Lung ultrasound(LUS)has gained increasing popularity among intensivists in recent dec-ades.Although limited by the presence of air,LUS has proved to be useful in the evaluation of a number of different acute and chronic conditions,such as pneumonia,pneumothorax,acute lung injury,alveolar-intersti-tial syndrome,pleural effusion,etc,and showed a relatively higher sensitivity,specificity and diagnostic accu-racy compared to routine radiographic imaging.It is also critical in improving the safety of pleural interven-tional procedures.The most common signs for diagnosing and differential diagnosing include the pleural line, lung sliding,the A-line,the quad sign,the sinusoid sign,the fractal,and tissue-like sign,the B-line,lung rock-ets,abolished lung sliding with the barcode sign,the lung point,the dynamic air bronchogram,etc.The BLUE-protocol allows differential diagnosis of acute respiratory failure.LUS is a feasible technique that can be used routinely and integrated into clinical practice in the fields of intensive care,emergency care,respirato-ry and general medicine.

Objective To investigate the effect of dexmedetomidine on the renal function and the expression of tight junction protein ZO-1 and occluding in the kidney of rats with septicopyemia induced by lipopolysaccharide.Methods Thirty adult male SD rats were randomly divided into 3 groups ( n=10 each):control group( group C) , LPS group ( group M) , and dexmedetomidine group ( group Dex ) .In the groups Dex and LPS, the rats were infused with saline and lipopolysaccharide (5 mg/kg, i.v.) respectively.In the Dex group, after intravenous injection of lipopolysaccharide (5 mg/kg) , the rats were firstly infused the loaded dose of dexmedetomidine (7μg/kg) for 15 minutes, and then changed to 5 μg/kg· min for 30 minutes.Blood samples were collected at 24 h later for measuring TNF-α, IL-1β, Scr and BUN.The kidney tissues were examined by histopathology.The expression of ZO-1 and occludin was detected by Western blot. Results Compared with the group C, the kidney tissue of group M was extensively damaged with tubular dilatation and inflammation, while reduced in the group Dex.Compared with the group C, the expressions of Scr, BUN, IL-1βand TNF-αwere all enhanced in the groups M and Dex ( P <0.05 ) , while the inflammatory factors in the group Dex were significantly lower than those of the group M ( P <0.05 ) .The Results The Western blot analysis showed that the expressions of protein ZO-1 and occludin in the group Dex were significantly higher than those of the group M (P<0.05). Conclusions Dexmedetomidine can improve the renal function of rats with septicopyemia, inhibit the acute renal injury and inflammation, increase the expression of protein ZO-1, and exert certain protective effect on the kidneys.

Adolescent ; Female ; Heart Septal Defects, Atrial ; complications ; therapy ; Humans ; Male ; Pulmonary Veins ; abnormalities ; Young Adult

Objective To study the mechanism of sacral plexus injury resulting from anteroposteri- or compression zone-Ⅱsacral fractures.Methods Six short-term(within one year)embalmed pelves were obtained from Anatomic Department of Hebei Medical University.The preserved sacral plexus and re- sected pubic symphysis were used to make the models of anteropesterior compression zone-Ⅱsacral frac- tures.Quantitative analysis for fracture displacement was carried out to observe the characteristics and mechanism of sacral plexus injury.The removed sacral plexus was replaced by proportional diameter silica gel pips filled with contrast medium.The experimental procedure was repeated under X-ray.The experi- mental data were analyzed by SPSS 10.0 statistic software to obtain result.Results In anteropostefior compression sacral fracture,sacral nerve canal was gradually opened and its volume raised.No sacral nerve was opressed in nerve canal.However ilium external rotation prolonged sacral nerves,especially S_1,S_4 and the more the pubic symphsis was separated the more the sacral plexus nerves were prolonged.At the same time,the sharp border of fracture segment stabbed the nerves,especially L_5(6 cases),S_1(5 cases)and S_2 (3 eases).Conclsions Sacral plexus is tightly connected with the wall of pelvic cavity and fixed. When zone-Ⅱsacral fractures happen sacral plexus is easily damaged.In anteroposterior compression sacral fracture,nerves S_1 and S_4 are likely to be damaged by dragment,and nerve compression injury is attributed to stabbing by fracture segment border,with L_5 and S_1.more hackneyed.

Objective To investigate the clinical application of ultrasound biomicroscopy in the treatment of congenital corneal opacities.Methods Medical records of 20 eyes (15 patients) with congenital corneal opacity treated at our hospital from July 2004 to November 2011 were retrospectively reviewed.Best corrected visual acuity testing,intraocular pressure testing,slit-lamp anterior segment examination,fundus examination,slit-lamp microscopic photography,B scan examination,and ultrasound biomicroscopy were performed for analysis of complications of congenital corneal opacity and selection of surgical approaches.Results The ultrasound biomicroscopic examination showed that 5 eyes had no Descemet's membrane and corneal endothelium,20 eyes had anterior synechia,5 eyes had aniridia,3 eyes had loss of lens cortex,13 eyes had cataract,14 eyes had closed angle,and 3 eyes had pupillary membrane.14 of 20 eyes received surgical treatment,including penetrating keratoplasty combined with cataract extraction and trabeculectomy (5 eyes),penetrating keratoplasty combined with pupil angioplasty (3 eyes),penetrating keratoplasty combined with cataract extraction (3 eyes),penetrating keratoplasty combined with trabeculectomy (2 eyes),and lamellar keratoplasty (1 eye).Conclusions Ultrasound biomicroscopy is important to guide the diagnosis and treatment of congenital corneal opacity.

Objective To explore the total treatment effect,layered diagnostic treatment effect,the relationship between effect and site of infection and common side effects of commonly used antifungal agents such as itraconazole,Voriconazole,caspofungin and amphotericin B liposome in invasive fungal infection with hematologic malignancies.Methods The clinical data of 117 cases of patients with hematologic malignancies combining with invasive fungal infection hospitalized in our department from Jan,2005 to Aug,2008 were retrospectively analyzed.Results The total effect rates of itraconazole,Voriconazole,caspofungin and amphotericin B liposome were 69.0%(40/58),77.4%(24/31),64.7%(11/17)and 63.6%(7/11)respectivley(P=0.726).In patients with pulmonary infection,the effect rates of the agents were 63.0%(17/27),85.7%(12/14),50.0%(4/8)and 62.5%(5/8)respectively(P=0.283),which itraconazole group was higher than that of the other agents.The effect rates of the 4 groups have similar rates in patients with liver and spleen candidiasis,fungemia and infections with unknown origin.The rates of 6 weeks survival were 86.2%,87.1%,70.6% and 72.7% respectively.The common side effects of itraconazole and Voriconazole were mainly gastrointestinal reaction and mild hypokalemia.There were few patients showed gastrointestinal reaction(12.1%) and hypokalemia(20.7%)in the former.Some individual showed visual abnormity(9.7%)and external vertebral body symptoms(6.4%).caspofungin showed mild toxic and side effects,which was only gastrointestinal reaction(15.4%),while they were common in amphotericin B liposome group,which were Chill and fever(81.8%),hypokalemia(100%),gastrointestinal reaction(18.2%)and liver damage(9.1%).Conclusion The total effect,layered diagnostic effect and 6 weeks survival rates were similar in itraconazole,Voriconazole,caspofungin and amphotericin B liposome in patients with hematologic malignancies combining with invasive fungal infection.

Images of 812 patients undergoing dual-source CT coronary angiography were analyzed retrospectively. Effectively nursing can be improved to guarantee the quality of coronary angiography and diagnosis of diseases.

Objective: Our purpose was to study the predictive factors of interferon(IFN) therapeutic effectiveness. Methods:Genotypes of HCV, HCV RNA quantities, β2 microglobulin, 2′- 5′oligoadenylate synthetase, and peripheral blood lymohocyte subgroup were detected by using specific primer PCR assay, energy transference technique of signal primer, sheet chromatography, radioimmunoassay, and APAAP immunoenzyme bridge technique respectively in 20 blood samples of patients with chronic hepatitis C. Results:(1)The patients who had lower level of HCV RNA before treatment and had continuing decreased HCV RNA level after treatment had good response to IFN treatment in follow-up survey. (2)The patients with HCV-Ⅲ type had complete response much more than those with HCV-Ⅱ type (P＜0.05).(3)The patients with lower level of 2′- 5′oligoadenylate synthetase before treatment might have good response to IFN treatment. (4) There was no significant change in β2 microglobulin level before and after treatment and in different response groups before treatment.(5) The CD+3, CD+4, and CD+4/CD+8 in peripheral blood increased after treatment. The patients in complete response group had higher level CD+3, CD+4, and CD+4/CD+8 than those in part response and non-response groups, but there was no significance in statisitcs. Conclusion:The HCV RNA quantities, HCV genotypes, 2′- 5′oligoadenylate synthetase level before treatment were predictive factors of IFN therapeutic effectiveness. The changes of HCV RNA level in treatment and follow-up survey had important significance in therapeutic evaluation, β2 microglobulin level, and lymphocyte subgroup before treatment were not used as predictive factors for IFN therapeutic effectiveness.

Adult ; Female ; Fluoride Poisoning ; Humans ; Male ; Middle Aged ; Occupational Diseases