Objective To investigate the pathogen spectrum and analyze the associated risk factors of pulmonary moniliasis in the patients with liver failure.Methods A retrospective analysis of pulmonary moniliasis complicating liver failure(n=150) was performed by case-control study on the data of patients admitted to PLA 302 Hospital from Jan.1986 to Nov.2007.A cohort of 154 patients with liver failure but without fungi infection(n=154) served as the control group.By analyzing the epidemiological and clinical data,the spectrum of fungi was identified,and the risk factors in pulmonary moniliasis pneumonia inpatients with liver failure were identified.Results The number of patients with acute on chronic liver failure(69/150,46.0%) were greater than patients with chronic liver failure(78/150,52.0%),while the number of patients suffering from moniliasis pneumonia was smaller than that of control group(20/154,13.0% and 129/154,83.8%,respectively,P

Objective To investigate the influence of citalopram on the fast response action potential,slow response action potential,in vitro electrocardiogram(ECG) and in vivo ECG of cardiac myocytes,and explore its mechanism of adverse cardiac effects. Methods Conventional microelectrode technique was employed to record the fast and slow response action potentials of the isolated papillary muscles of guinea pigs.In vivo and in vitro ECG were recorded from anesthetized animals and Langendorff-perfused hearts,respectively. Results Citalopram could prolong the RR interval and QRS duration of in vivo ECG.The premature ventricular contraction and atrial ventricular block were induced by 12.5?10-6 mol/L citalopram.The maximum ascending velocity of 0 phase(Vmax),action potential amplitude(APA) and action potential duration(APD50 and APD90) were dose-dependently decreased by citalopram in the fast and slow response action potentials of guinea pigs,respectively. Conclusion Citalopram can inhibit sodium and calcium channels effectively,which may be the ionic mechanism that citalopram induces arrhythmia in the clinical practice.

OBJECTIVETo evaluate the functional outcomes of modified limited "L" incision beside the Achilles tendon with distraction bone block arthrodesis in treatment of subtalar osteoarthritis.

METHODSFrom March 2009 to September 2012, a total of 22 cases of old calcaneus fractures with subtalar osteoarthritis were treated with modified limited "L" incision and distraction bone block arthrodesis including 13 males and 9 females with a mean age of 35.3 years old (ranged 22 to 49). The mean time from calcaneal fracture was 21 months (ranged 11 to 32). According to the Stephens-Sanders classification, 16 cases were type II and 6 were type III. The modified-AOFAS ankle-hindfoot score was used for functional outcomes evaluation.

RESULTSThere was one incision necrosis and no infection, implant failure, bone-graft absorbed or talus necrosis was note at the follow-up time. A total of 21 cases were followed up for a mean time of 29 months (ranged from 18 to 46 months). All of the cases reached a bony union within 4 months postoperation. The mean modified-AOFAS ankle-hindfoot score was 82.6 points (ranged from 66 to 92 points),reached a significantly improvement in comparing with the mean preoperative score (50.8 points,ranged from 32 to 65 points, P < 0.01).

CONCLUSIONThe modified limited"L" incision beside the Achilles tendon with distraction bone block arthrodesis is an acceptable and alternative treatment method for subtalar osteoarthritis. This method is easy to use and with less complication. It can correct the main pathological changes and reach good functional outcomes.

Adult ; Arthrodesis ; methods ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis ; surgery ; Subtalar Joint ; surgery

AIM: To analyze and identify the phosphoproteins associated with diazoxide preconditioning. METHODS: Proteomics technique was used to investigate the changes of phosphoprotein after diazoxide preconditioning. Adult rat ventricular myocytes were pretreated in the presence and absence of 200 ?mol/L diazoxide for 10 min. Phosphoproteins prepared and enriched respectively from control and diazoxide pretreated groups were then separated by two-dimensional (2D) gel electrophoresis and stained with sliver staining kit. Phosphoproteins of interest were further identified by mass spectrometry. RESULTS: Associated with diazoxide preconditioning, the proteins of chaperonin containing TCP-1 and hypothetical protein XP_346548 were phosphorylated significantly. The proteins of 94 kD glucose-regulated protein, calpactin I heavy chain and ferritin were dephosphorylated markedly (P

A method for measuring 13C isotopic abundance of intracellular metabolites of Saccharopolysporaerythraea by ultra-high performance liquid chromatography (UPLC)-triple quadrupole mass spectrometry was established.First, the chromatographic conditions of UPLC were optimized, and then the MS conditions such as unique tube lens voltage, collision energy, and ion pair were optimized.On the bases of length of the parent and daughter ions carbon chains and whether the daughter ions contain 13C atoms, the one-to-one method, one-to-many method and SIM method were established for measuring 13C isotopic abundance.Then these methods were used to measure naturally labeled intracellular metabolite standards and 13C labeled samples, and according to the gap between the experimental value and the theoretical value, the best method was established for each metabolite of different characteristics.The results showed that one-to-one method was most effective for measuring the metabolites of daughter ions not containing 13C atoms represented by sugar phosphates, one-to-many method was the best for measuring the metabolites of both parent and daughter ions containing 13C short carbon chains represented by carboxylic acids, SIM method could play a role in measuring the metabolites of both parent and daughter ions containing 13C long carbon chains represented by coenzyme A.This method had a good measurement precision and could be applied to the measurement of Saccharopolysporaerythraea intracellular metabolites, which contributed to the consequent study of metabolic mechanism and the efficient expression of erythromycin.

BACKGROUND: Traditional orthodontic anchorage has the disadvantages of discomfort, difficult to control, affecting the appearance, and relying on patient’s close cooperation. Because of short-time clinical research and application, mini-implant anchorage has a great controversy in the orthodontic treatment. OBJECTIVE: To explore the application value of mini-implant anchorage in the orthodontic treatment. METHODS:Eighty cases undergoing the orthodontic treatment at the Center of Ophthalmology and Otolaryngology, Yaan People’s Hospital in China from January 2012 to June 2015 were enrol ed in this study. These patients were equal y randomized into test group and control group, which were subjected to mini-implant anchorage or headgear anchorage, respectively. The treatment was continued for 2 years in the two groups. RESULTS AND CONCLUSION: After the treatment, the successful rate in the test group was significantly higher than that in the control group (P < 0.05); the upper central incisor convex distance difference, inclination angle of the upper central incisor, displacement of the molar, SNA angle, inter-canine width, were significantly better in the test group than the control group (P < 0.05). At weeks 4 and 8 after intervention, there was no difference in the expression of osteoprotegerin in the periodontal tissue between the two groups (P > 0.05), but the rate of adverse reactions was significantly lower in the test group than the control group (P < 0.05). These findings indicate the mini-implant anchorage method can significantly improve the therapeutic efficacy, improve the success rate of treatment, and reduce the incidence of postoperative infections, which has good safety and stability, and has good clinical application value.

Objective To investigate the effect of ultrasound-guided serratus plane (SP) block on efficacy of postoperative analgesia in patients undergoing radical mastectomy.Methods From February 2012 to October 2016,sixty American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ patients scheduled for radical mastectomy under general anesthesia were randomly divided into two groups (n =30 each):SP block group (observation group) and control group.After induction of anesthesia,ultrasoundguided homolateral SP block was performed,and 0.375％ ropivacaine 20 ml was injected in observation group,while the equal volume of normal saline was used instead in control group.The patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after operation in the two groups.The scores of prince henry pain scale (PHPS) were evaluated at 2,4,8,12 and 24 hours (T1,T2,T3,T4,T5) after operation.The consumption of sufentanil,propofol and remifentanil were recorded,meantime the times of successfully delivered doses (D1) and attempts (D2) within 24 h after operation were added up,calculating D1/D2.The adverse effects were also recorded.Results The scores of PHPS at T1 [(1.4 ± 0.6) scores vs (3.1 ±0.7) scores],T2 [(1.5 ±0.7) scores vs (2.9 ±0.9) scores],T3 [(1.7 ±0.6) scores vs (2.8±0.8) scores],and the consumption of sufentanil [(53.4 ± 16.8) μg vs (87.8 ±24.6) μg],remifentanil [(288.7 ±42.2) μg vs (376.5 ±61.7) μg] were significantly lower in observation group than in control group,while D1/D2 (0.89 ±0.13 vs 0.57 ±0.19) was higher (P ＜0.05).The incidence of adverse reactions was significantly lower in the observation group (0 vs 23.3 ％) (P ＜ 0.05).Conclusions Ultrasound-guided SP block reduces the consumption of perioperative opioids and enhances the efficacy of postoperative analgesia in patients undergoing radical mastectomy.

objective To analyze the clinicopathological features and prognosis of antiglomerular basement membrane(GBM)disease,and evaluate the efficacy and safety of double filtration plasmapheresis(DFPP). Methods A total of 35 hospitalized patients diagnosed as anti-GBM disease in our department were enrolled in the study.All the patients were divided into 3 groups according to the manifestations at admission.Group Ⅰ∶24 patients with severe pulmonary hemorrhage or rapidly progressive glomerulonephritis(RPGN)received pulse methylprednisolone with or without DFPP,and then followed by prednisone and CTX.Group Ⅱ∶5 patients without severe pulmonary hemorrhage and RPGN received prednisone and CTX.Group Ⅲ∶5 ESRD patients and 1 normal renal function patient did not receive immunosuppression therapy.Anti-GBM antibody titer of pre-and post-DFPP in 4 patients was measured consecutively,and removal rate was calculated.Results The mean age of all the patients was(41.1±16.6)years.Sixteen patients(45.7%)presented Goodpasture's syndrome.Eighteen patients(51.4%)had anti-GBM glomerulonephritis alone,whereas one suffered solely from pulmonary hemorrhage.20%patients had positive P-ANCA serology.54.2%crescentic glomerulonephritis and 7 with other glomerulonephritis were revealed by kidney biopsy in 24 patients.Patients in Group Ⅰ showed more severe manifestation at admission:higher Scr level,higher titer of anit-GBM antibody,greater percentage of crescents.Within the follow-up period,7 patients died and kidneys of 50%patients survived.No patient died in Group Ⅱ and Ⅲ.The elder age,anemia,higher Scr(＞300 μmol/L),oliguria or anuria,emergency hemodialysis at admission,and more glomerular sclerosis were predictors of poor prognosis.The anti-GBM antibody was negative after 4 to 6 sessions of DFPP.and the mean removal rate was 55%.During total 94 DFPP sessions,there was no unacceptable morbidity. Conclusions Different therapy strategy is necessary for anti-GBM disease with different clinical manifestations.DFPP is an effective and safe clearance way of anti-GBM antibody.

OBJECTIVETo discuss the diagnosis and treatment of multiple trauma with mainly thoracic and abdominal injuries.

METHODSA retrospective analysis was performed on data of multiple trauma cases with mainly thoracic and/or abdominal injuries.

RESULTSOf 1166 cases, 72.3% were found with shock. The operation rates of thoracic and abdominal injuries were 14.8% (119/804) and 83.5% (710/850) respectively (X(2) equal to 780.683, P less than 0.01). The operation rates of blunt and penetrating thoracic injuries was 6.8% (42/617) and 40.6% (76/187) respectively (X(2) equal to 131.701, P less than 0.01). The operation rates of blunt and penetrating abdominal injuries were 77.1% (434/563) and 96.1% (276/287) respectively (X(2) equal to 50.302, P less than 0.01). The operation rates of blunt thoracio-abdominal injuries were 6.8% (42/617) in thoracic region and 77.1% (434/563) in abdomen respectively (X(2) equal to 544.043, P less than 0.01). Among the cases of abdominal injuries, 41 received arteriography embolism, with the efficacy of 95.1% (39/41). Total mortality rate was 6.1%. The mortality rates of blunt and penetrating injuries were 7.3% (62/854) and 2.9% (9/312) (X(2) equal to 6.51, P less than 0.005). The deaths were mainly due to large volume of blood loss.

CONCLUSIONSWhen both thoracic and abdominal injuries exist, laparotomy is frequently required rather than thoracotomy. Laparotomy is seldomly used for blunt thoracic injuries, but usually used for penetrating thoracic and abdominal injuries. Mortality rate of penetrating thoracic and abdominal injuries is markedly lower than that of blunt injuries. Surgical operation is still important for those patients with penetrating thoracic or abdominal injuries.

Abdominal Injuries ; surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Male ; Middle Aged ; Multiple Trauma ; surgery ; Retrospective Studies ; Thoracic Injuries ; surgery ; Wounds, Nonpenetrating ; surgery ; Wounds, Penetrating ; surgery ; Young Adult

OBJECTIVETo probe the feasibility and efficacy of damage control orthopedics (DCO) in treating severe multiple injuries.

METHODSA retrospective analysis was made on the clinical data of 41 patients (31 males and 10 females, aged 18-71 years, mean: 36.4) with multiple injuries admitted to our department and treated by DCO from January 1995 to December 2005.

RESULTSAs a first-stage therapy, devascularization of internal iliac arteries was performed in 29 patients with pelvic fractures combined with massive bleeding, including ligation of bilateral internal iliac arteries in 21 patients and embolization of bilateral internal iliac arteries in 8. And early external fixation of pelvis was performed in 10 patients. Ten patients with severe multiple injuries combined with femoral fractures were managed with primary debridement and temporal external fixation and 2 patients with spinal fractures combined with spinal cord compression received simple laminectomy. Thirty-one patients received definite internal fixation after resuscitation in intensive care unit. The overall mortality rate was 12.1% (5/41) with an average injury severity score of 41.4. The main causes of death were hemorrhagic shock and associated injuries. Complications occurred in 7 patients including acute respiratory distress syndrome in 3 cases, thrombosis of right common iliac artery in 1, subphernic abscess in 2 and infection of deep wound in lower extremity in 1. After treatment, all the patients got cured.

CONCLUSIONSPrompt diagnosis and integrated treatment are keys to higher survival rate in patients with severe multiple injuries. In this condition, DCO is an effective and safe option.

Adolescent ; Adult ; Aged ; Critical Care ; methods ; Female ; Humans ; Male ; Middle Aged ; Multiple Trauma ; mortality ; surgery ; Orthopedic Procedures ; methods ; Retrospective Studies