Objective To investigate the pathological features and significance of m yocardial contraction band necrosis in sudden cardiac death. Methods Using HE and PTA Hstaining, the distribution sites and pathological features of m yocardial contraction band necrosis were observed. The data were analyzed accord-ing to the extent of necrosis. Results The locations, pathological features and the extent of necrosis were sim ilar in different sudden death cases. The locations were related with sites of m yocardial dam age. The papillary m uscles of left ventricular were m ost occurred, followed by the anterior wall of left ventricular. In the sudden death cases caused by stress cardiom yopathy, the extent of m yocardial contraction band necrosis was lighter than the others. Most cases were predom inantly level 1, the others were level 2. Conclusion Used as the diagnosis basis of acute m yocardial ischem ia, the m yocardial contraction band necrosis has im portant significance to determ ination of death.

Objective To compare the efficacy of three procedures,extracorporeal shock wave lithotripsy(ESWL),ureteroscopic lithotripsy(URL) combined with ESWL,and minimally invasive percutaneous nephrolithotomy(MPCNL),for the treatment of complicated upper ureteral calculi.Methods Two hundred and thirty-four cases of complicated upper ureteral calculi were treated in this hospital from December 2002 to December 2003,including 76 cases of ESWL,78 cases of combined use of URL and ESWL,and 80 cases of MPCNL.Results In the ESWL cases,the stone fragmentation rate on one session was 56.6%((43/76),) the stone-free rate one month after operation was 46.1%(35/76),the mean hospitalization expenditure was 912 yuan,and the incidence of postoperative complications was 15.8%(12/76).In the URL combined with ESWL cases,the stone fragmentation rate on one session was 100%(78/78),the stone-free rate one month after operation was 83.3%(65/78),the mean hospitalization expenditure was 7 720 yuan,and the incidence of postoperative complications was 15.4%(12/78).In the MPCNL cases,the stone fragmentation rate on one session was 100%(80/80),the stone-free rate one month after operation was 100%(80/80),the mean hospitalization expenditure was 10 253 yuan,and the incidence of postoperative complications was 13.8%(11/80).The operation time,intraoperative blood loss,length of hospital stay,stone-free rate one month after operation,and hospitalization expenditure were significantly greater in the MPCNL cases than in the ESWL cases and the URL combined with ESWL cases.The stone fragmentation rate on one session was not significantly different between the MPCNL cases and the URL combined with ESWL cases,and was significantly higher in the MPCNL cases and the URL combined with ESWL cases than in the ESWL cases.The incidence of postoperative complications was not significantly different among the three groups.Conclusions Minimally invasive percutaneous nephrolithotomy should be used as the first choice for complicated upper ureteral calculi.

Anesthesia plays an essential role in clinical operations. Guiding anesthesia by EEG signals is one of the most promising methods at present and it has obtained good results. The analysis and process of the EEG signals in anesthesia can provide clean signal for further research. This paper used variance threshold method to remove the mutation fast and large interfering signals; and used notch filter to remove frequency interference, smoothing filter to remove baseline drift and Butterworth low-pass filter to remove high frequency noise at the same time. In addition to this, the translation invariant wavelet method to remove interference noise on the signals which was after the classical filter and retained non-stationary characteristics was used to evaluate parameter calculation. By comparing the calculated parameters from treated signal using this paper's methods and untreated signal and standard signal, the standard deviation and correlation has been improved, particularly the major parameters BetaR, which provides better signal for integration of multi-parameter to evaluate depth of anesthesia index for the latter.
Anesthesia ; methods ; Humans ; Signal Processing, Computer-Assisted

Objective To explore the etiology and the fungi distribution in patients with complex renal calculi,as well as the therapeutic efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL).Methods The mid-stream urine culture was underwent in 891 cases of patients with complex renal calculi.The MPCNL were performed in patients with complex renal calculi combined with fungous infection.Results Of 891 patients with complex renal calculi,3.7%(33/891) patients were presented with fungous infection,including 60.61%(20/33) with Candida albicans and 39.39%(13/33) with Candida glabrata.All the 33 patients had long-term use of broad spectrum antibiotics from 25 to 92 days(averaged 45.8 days).The patients with complex renal calculi combined with fungous infection were treated with MPCNL.The stone-free rate was 87.88%(29/33) and the insignificance stone-residual rate was 12.12%(4/33).Conclusion The patients with complex renal calculi are apt to fungous infection and the abuse of broad spectrum antibiotics should be avoided.The MPCNL is safe and reliable for the treatment of the patients with complex renal calculi combined with fungous infection.

Objective To observe the changes in inflammatory mediators in plasma in respiratory distress syndrome(RDS) of neonates received lung protective ventilation treatment. Methods Sixty newborn infants,diagnosed as RDS of neonatal and needed ventilator support, were recruited from the intensive care unit from May 2003 to May 2006. Infant with RDS were randomly divided into two groups. Both had 30 newborn infants. The infants in the experimental groups received lung protective ventilation treatment tidal volume:5-8 ml/kg,positive end-expiratory pressure (PEEP):0.51~0.98 kPa, and the control groups received large tidal volume ventilation (tidal volume:10-15 ml/kg,PEEP:0-0.29 kPa). The contents of TNF-?, interleukin-6 in plasma were measured. Results After those two therapies, the contents of tumor necrosis factor-?(TNF-?), interleukin-6 in plasma decreased obviously, especially after receiving lung protective ventilation treatment. Conclusions There are statistical differences in the amount of inflammatory mediators released between the experimental group under lung protective ventilation treatment and the control group received large tidal volume ventilation,and better effects are seen in RDS infants under lung protective ventilation treatment .

Objective To explore the protective ventilation strategies in hyaline membmne disease(HMD) of neonates,in order to decrease the incidence of ventilator-associated lung injury(VAU).Methods 68 newborn infants,diagnosed as of neonatal hyaline membrane disease and needed ventilator support,were recruited from the neonatal intensive care unit from 2003 to 2005.Infant with HMD were divided into the conventional ventilation practice group (the control group) and protective ventilation strategies group (the experimental group).The ventilator settinns,artery blood gas analysis,ventilator-associated lung injury and other clinical data were analyzed and compared.Results The incidence of ventilator-associated lung injury in the experimental group wag significantly lower than that in the cntrol group(2.94% VS 17.6%,P＜0.05).PaCO2 in experimental group was significantly higher than that in control group.The mortality in the experimental group was significantly lower than that in control group.Condusion The protective ventilation strategies can decrease the incidence of ventilator-associated lung injury in neonatal HMD.the protective ventilation strategies can decrease the mortality in neonatal HMD.

Objective To observe the changes and clinical significance of procalcitonin(PCT) level in children with bacterial pneumonia.Methods The levels of PCT,hs-CRP and WBC were detected in 31 pneumonia children pre and post antibiotic treatment,and the changes were observed.Results The PCT levels of the 31 patients were all increased before treatment.After cured,PCT level of 28 cases returned to normal.But in the 28 normal cases,WBC level increased in 10 cases(35.7％),and hs-CRP level elevated in 4 cases(14.3％).In the other 3 cases,the PCT levels decreased from 5.69ng/mL,1.25ng/mL and 0.83ng/mL at admission to 0.51ng/mL,0.55ng/mL and 0.52ng/mL,respectively.And in these 3 cases,there was one case with the levels of WBC and hs-CRP respectively ascended,in which WBC level descended from 13.1 × 109/L to 12.1 × 109/L and hs-CRP level reduced from 20.92mg/L to 7.38mg/L.Conclusion The sensitivity of the index PCT is the highest at the accurate time phase of bacterial pneumonia,which can guide the reasonable use of antibiotics.

ObjectiveTo study the curative effect of early intervention on selective head sub-hypothermia in full term infant with severe asphyxia.MethodsForty two full term infant with severe asphyxia were randomly divided into treatment(n =22) and control ( n =20) group,all patients were treated according to three supportive therapy and three heteropathy after resuscitation,and meanwhile the treament group combined with selective head sub-hypothermia.In the 2 groups,heart and breath oxygen saturation,blood sugar were measurded within 72 hours after treatment,and the Chinese 20-item neonate nerve behaviors were evaluated 28 days after birth.Test were conducted with the Bayley infant development scale in 2 months after birth.ResultsAfter 72 hours of treatment,the heart rate of treatment group reduced and showed significant difference from that of contol group and restored to normal.There were no significant differences in breath,blood pressure(BP),degree of blood ozygen saturation,blood sugar between the 2 groups.After 28 days of birth,scores of neonate nerve behaviors were ( 37 ± 3) in treatment group and (31 ± 3) in control group,respectively ;which showed significant difference ( P ＜ 0.01 ).In the 2nd months of birth,scores of Bayley infant development scale were (91 ± 3 ) in treatment group and ( 86 ± 4 ) in control group,respectively,which showed significant difference(P ＜ 0.05 ).ConclusionSelective head sub-hypothermia was convenient and safe,and had reliable curative effect by relieving or prenventing sequel and raising quality of life.

Objective To investigate the changes of fibrinogen and D -dimer levels in patients with severe burn and their relationship with prognosis .Methods 90 patients with severe burn were selected as the subjects .The patients were divided into the dead group (30 cases) and the survival group (60 cases) according to the prognosis of the patients.The differences and changes of fibrinogen and D -dimer at the same time after admission were compared between the two groups .Results At each time point after admission , the fibrinogen levels of the death group were significantly higher than those of the survival group at the same time [(5.9 ±1.5)g/L vs.(5.1 ±1.3)g/L,(8.8 ± 2.2)g/L vs.(7.4 ±2.5)g/L,(7.6 ±2.8)g/L vs.(5.7 ±1.2)g/L,(7.1 ±2.5)g/L vs.(4.3 ±1.7)g/L],the differences were statistically significant(t =3.892,4.762,5.436,6.987,all P <0.05).At each time point after admission,the D-dimer levels of the death group were significantly higher than those of the survival group at the same time[(743.4 ±226.2)ng/mL vs.(704.1 ±214.6)ng/mL,(935.4 ±256.9)ng/mL vs.(834.6 ±256.2)ng/mL, (846.3 ±291.5)ng/mL vs.(712.1 ±251.3) ng/mL,(756.7 ±232.8) ng/mL vs.(601.5 ±168.7) ng/mL],the differences were statistically significant (t=3.895,5.477,4.743,5.746,all P<0.05).The level of D-dimer in the survival group showed a rise firstly ,then showed a decrease trend after admission ,while the levels of fibrinogen and D-dimer of the death group were altered in double -peak change .Conclusion There is an obvious impairment of coagulation function in severe burn patients , and the level of D -dimer and fibrinogen is higher , the prognosis of patients is worse .