Objective To observe the therapeutic effect and prognosis of patients with severe traumatic craniocerebral injury treated by Lund program combined with Angong Niuhuang pill. Methods A prospective study was conducted. Forty-nine patients with severe traumatic craniocerebral injury were divided into two groups:combined treatment group (25 cases) and control group (24 cases). All the patients in the two groups received conventional therapy. Additionally, the combined treatment group was treated by the Lund program combined with Angong Niuhuang pill, the patients after admission into the intensive care unit (ICU), indwelling of gastric tube was immediately given (the tube inserted and retained through mouth in cases with cranial base bone fracture), one pill of Angong Niuhuang was fed nasally twice a day for consecutive 15 days. Before and after treatment, the intracranial pressure (ICP), cerebral perfusion pressure (CPP), Glasgow coma scale (GCS) score, the mean flow velocity of middle cerebral artery (MCA), and the incidence of complication, clinical efficacy and prognosis in the two groups were observed. Results There were no statistically significant differences in the levels of ICP, CPP, GCS score and the average flow velocity of MCA before treatment and the first day after treatment between the two groups. Beginning from 3 days after treatment, the degrees of improvement in the above indexes in the combination treatment group became much better than those in the control group [ICP (mmHg, 1 mmHg=0.133 kPa):16.78±4.50 vs. 18.80±5.67, CPP (mmHg):71.35±1.63 vs. 58.11±1.47, GCS score:9.53±0.38 vs. 8.23±0.44, the mean blood flow velocity (cm/s):152.23±3.33 vs. 178.86±5.23, all P<0.05]. The incidences of complications such as hyperpyrexia [8.0%(2/25) vs. 41.7%(10/24)], hyperspasmia [12.0%(3/25) vs. 45.8%(11/24)] and cerebral hernia [8.0%(2/25) vs. 33.3%(8/24)] in the combined treatment group were significantly lower than those in the control group (all P < 0.05). The rates of renal failure, electrolyte imbalance and pulmonary infection in combined treatment group were also lower than those in the control group, but the differences were not statistically significant (all P>0.05). The rate of good therapeutic effect in combination treatment group was obviously higher than that of the control group [72.0% (18/25) vs. 33.3% (8/24), P < 0.05], while the mortality was markedly lowered [8.0% (2/25) vs. 33.3% (8/24), P < 0.05]. Conclusions The combination of Lund program and Angong Niuhuang pills for treatment of patients with severe traumatic craniocerebral injury can reduce the degree of increase of ICP at early stage, ameliorate cerebral edema and its development, elevate CPP and improve cerebral ischemia and hypoxia. In the aspects of controlling hyperpyrexia, decreasing limbs twitches and the incidence of hernia, elevating the quality of patients' life, reducing mortality and improving prognosis, the therapy has relatively good therapeutic effects.

Accidents, Occupational ; statistics & numerical data ; Adolescent ; Adult ; Cross-Over Studies ; Female ; Hand Injuries ; etiology ; Humans ; Male ; Middle Aged ; Risk Factors ; Surveys and Questionnaires ; Young Adult

Objective To investigate whether velocity vector imaging (VVI) combined with stress echocardiography could detect potential myocardial impairment of the left ventricle(LV) in diabetic rats.Methods DM rats ( n = 18,administered by STZ at 65 mg/kg) and control rats( n = 12) were performed with VVI and M-mode echocardiography both at rest and after dipyridamole stress 12 weeks later. Twodimensional echocardiographic cine loops and M-mode images of three consecutive beats were obtained from the short-axis views at the mid-LV level. The means of segmental peak systolic velocity(Vs), circumferential strain(εc) ,radial strain(εr), systolic circumferential and radial strain rate (SRc, SRr) and the percent wall thickening (WT% ,derived from M-mode) were obtained. After echocardiograms were performed,the hearts were excised and prepared for HE staining and ultrastructural observations under electron microscopy.Results At rest,only SRc in the DM group was significantly lower than that in the control group( P ＜0.05), the other parameters were statistically comparable between the two groups. After dipyridamole stress,all VVI values in the DM group were significantly lower than those in the control group ( P ＜0.05).However,there was no significant difference in WT% between the two groups either at rest or after dipyridamole stress ( P ＞0.05). Conclusions The VVI parameters combined with dipyridamole stress are more effective in evaluating potential myocardial impairment of the LV walls in diabetic rats. SRc might be more sensitive indices that can be used to detect myocardial impairment at rest.

Objective To investigate the value of DNA-image cyt-ometry (DNA-ICM) in the diagnosis of urothelial cell carcinomas (UCC). Methods Totally 162 voided urine specimens (92 cases from urothel-ial car-cinomas patients and 70 cases from benign urinary system diseases patients ) were detected with DNA-ICM and liquid-based cytology (LBC), respectively. Results The sensitivity and specificity of DNA-ICM were 65.2%and 100% respectively in the diagnosis of UCC but those of LBC were 27.2% and 98.6%, respectively. The sensitivity of DNA-ICM was significantly higher than that of LBC in the diagnosis of UCC (P < 0.01). The sen-sitivity of DNA-ICM in upper urinary tract urothelial cell carcinomas (UTUC) were 77.1%, which was much higher than that in bladder urothelial cell carcinomas (57.9%) but no statistical significance was found (P >0.01). Conclusion DNA-ICM, which improves the positive rate of urinary cytology, has great application value in the diagnosis of urothelial cell carcinomas and it is an effective screening method for urothelial cancer in diag-nosis and follow-up.

BACKGROUND:Numerous studies have focused on the clinical efficacy of alogeneic bone graft and humeral head replacement for the treatment of proximal humeral fractures, but their comparative studies are rarely reported. OBJECTIVE:To investigate the effect of alogeneic bone grafting in the treatment of proximal humeral fractures in the high risk group. METHODS:Clinical data of 120 cases of proximal humeral fractures aged≥ 60 years were retrospectively analyzed. Sixty of the 120 cases underwent alogeneic bone grafting combined with locking plate fixation as experimental group, and the other 60 cases were subjected to semi-shoulder joint replacement as control group. Al patients were folowed up for 8-24 months. Fracture healing, colodiaphyseal angle, humeral head height and shoulder joint function were observed and measured. RESULTS AND CONCLUSION:During the postoperative 8-24 months, al the fractures were healed by first intention, and there were no rejection reactions, large/smal nodules, humeral head displacement, necrosis, and screw loosening. Loss of the humeral head height at the last folow-up and the active flexion angle of the shoulder at postoperative 12 weeks were significantly higher in the experimental group than the control group (P < 0.05). Scores on forearm, shoulder and hand dysfunction were significantly lower in the experimental group than the control group (P < 0.05). However, no significant difference was observed in the colodiaphyseal angle and SF-36 scores between the two groups. These finding indicate that alogeneic bone grafting can strength the internal fixation of proximal humeral fractures in the high-risk group, and improve patient’s upper limb function.

Objective In order to further enhance the repeatability and comparability for antinuclear antibody testing results in clinical laboratory,explore the reliable preparation method,and develop the quality control serum that is capable of meeting the needs of routine antinuclear antibody testing.Methods According to selection requirements,the serum from patient which is used to test antinuclear antibody was selected,and then we prepared the quality control serum.through evaluation of index in appearance of serum,aseptic level,uniformity and stability in intra-assay and inter-assay etc,the study optimized the method and condition for preparation,also confirmed the performance of prepared quality control serum.Results Prepared quality control serums are able to preserved stable at-20 ℃ 270 d,it can be keep stable more than 8 h after rewarming at room temperature.There are no significant differences between the commercialization of quality control performance and the freez-thawed uniformity and stability in intra-assay and inter-assay,it are keep consistent to result that before freezing testing.Conclusions Suitable methods and experimental conditions are explored for preparation of antinuclear antibody testing quality control substance.Each batch of prepared quality control substance has good uniformity and stability.The prepared quality control serum are able to meet needs of antinuclear antibody testing,and meet quality control requirements.

Objective To evaluate the effect of alveolar recruitment maneuver on the perioperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.Methods Forty morbidly obese patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-64 yr,with body mass index ≥ 40 kg/m2,scheduled for elective laparoscopic sleeve gastrectomy,were randomly divided into either control group (group C) or alveolar recruitment maneuver group (group R) using a random number table,with 20 patients in each group.Patients in group C were treated with volume-or pressure-controlled ventilation after creation of pneumoperitoneum,maintaining the peak inspiratory pressure (Ppeak) ≤ 30 cmH2O and partial pressure of end-tidal CO2 35-40 mmHg.Patients in group R received alveolar recruitment maneuver once every 30 min starting from creation of pneumoperitoneum until the end of surgery.Patients were transfered to post-anesthesia care unit (PACU) with endotracheal tube which was extubated when the unified extubation standard was achieved in PACU.The patients who stayed in PACU for 2 h showing no indications for extubation were transfered to intensive care unit for continuous ventilation support.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,and at the end of pneumoperitoneum,blood samples were collected from the radial artery for blood gas analysis.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak,plateau pressure (Peat),and dynamic lung compliance were recorded.The time for achieving extubation standard and time for achieving the standard for discharge from PACU were recorded.Patients were followed up until discharge,and the feeding time and duration of hospital stay were recorded.Results Compared with group C,PaO2 and oxygenation index were significantly increased at 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak was decreased at 60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,Pplat was decreased at 60 and 90 min of pneumoperitoneum,the dynamic lung compliance was increased at 30,60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,and the time for achieving extubation standard,time for achieving the standard for discharge from PACU,feeding time,and duration of hospital stay were shortened in group R (P＜0.05 or 0.01).In group C,one patient did not present with indications for extubation and were transfered to intensive care unit for continuous ventilation support.Conclusion Intraoperative alveolar recruitment maneuver can effectively improve the intraoperative pulmonary function and promote the recovery of postoperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.

ObjeCtive To investigate the value of protein biochip in the diagnosis of Lyme borreliosis. Methods The serum IgM and IgG antibodies against flagellin were detected by flagellin coated-and N-hydroxysuccinimide (NHS) modified-biochips in 82 patients with neuroborreliosis (NB),35 patients with erythema migrans (EM) and 44 normal controls.The results were compared with those from enzyme-linked immunosorbent assays (ELISA) and Western blot.Results The levels of both IgM and IgG antibodies were significantly higher in the NB patients than those in the normal controls (P

0.05).However,there were significant differences in retinal sensitivity among the other abnormalities(P

ObjectiveTo investigate the effects of sevotlurane and isoflurane on blockade of adult nicotinic acetylcholine receptor (ε-nAChR) of skeletal muscle of rats by rocuronium.MethodsHEK293 cell line was provided by Molecular Biology Laboratory,Chonqing Medical University and cultured in DMEM liquid culture medium containing 10％ bovine calf serum at 37 ℃in incubator filled with 5％ CO2.ε-nAChR was expressed heterologously in HEK293 cell using liposome transfection technology.The whole cell patch clamp technology was used to establish the concentration-effect curves for inhibition of acetylcholine (ACh)-induced current.The 5％ inhibitory concentration values ( IC5 ),25 ％ inhibitory concentration values ( IC25 ) and 50％ inhibitory concentration values (IC50) for sevoflurane,isoflurane and rocuronium were calculated.Firstly the inhibitory effect of rocuronium at a concentration of IC25 was studied in the presence of sevoflurane and isoflurane at concentrations of IC5,IC25 and IC50.Subsequently the inhibitory effect of rocuronium at concentrations of IC5,IC25 and IC50 was studied in the presence of sevoflurane and isoflurane at a concentration of IC25.Inhibition of ACh-induced current amplitude was recorded.ResultsAt the concentrations of IC5,IC25 and IC50 sevoflurane or isoflurane had synergistical inhibitory effect on the current amplitude of ε-nAChR with rocuronium at the concentrations of IC5 and IC25,while had addition inhibitory effect on the current amplitude of ε-nAChR with rocuronium at the concentration of IC50.The inhibitory effect of sevoflurane at the concentration of IC5 on the current amplitude of ε-nAChR with rocuronium at the concentration of IC25 was weaker than that of isoflurane,while the inhibitory effect of sevoflurane at the concentration of IC50 on the current amplitude of ε-nAChR with rocuronium at the concentration of IC25 was stronger than that of isoflurane.The inhibitory effect of sevoflurane at the concentration of IC25 on the current amplitude of ε-nAChR with rocuronium at the concentration of IC5 was weaker than that of isoflurane.ConclusionEither sevoflurane or isoflurane has synergistical blocking effect on ε-nAChR with low concentration of rocuronium,while has addition blocking effect with high concentration of rocuronium.Potentiation of blocking effect of rocuronium on ε-nAChR by low concentration of sevoflurane is weaker than that by isoflurane,while the potentiation by sevoflurane at high concentration is stronger than that by isoflurane.