Objective To investigate the effect of early goal lactate clearance rate therapy in patients with severe sepsis or septic shock.Methods Articles were retrieved from PubMed,Embase,Cochrane Library,Wanfang and CNKI before March 5,2016.Inclusion criteria included the subjects concerning patients with severe sepsis or septic shock reported as randomized controlled trial (RCT),which endpoints were the mortality,the length of ICU stay and hospital stay.RevMan 5.3 software was used for Meta analysis.Results There were 5 RCTs meeting inclusive criteria including 860 patients.It was shown by Meta analysis that early goal lactate clearance rate therapy was associated with decrease in the 28-day mortality(RR =0.73,95％ CI:0.60-0.88,P ＜ 0.01),shorten the length of ICU stay (WMD =-2.41,95％ CI:-4.68--0.14,P ＜ 0.05),but not associated with decrease of the length of hospital stay(WMD =-0.13,95 ％ CI:-4.58-4.31,P =0.95).Conclusion Early goal lactate clearance rate therapy was associated with significant improvement in 28-day mortality and the length of ICU stay but not with the length of hospital stay in patients with severe sepsis or septic shock.

Aim To investigate the effects of Cariporide on expression of intercellular adhesion molecule-1(ICAM-1) and P-selectin and adhesion of monocytes and endothelial cells induced by lysophophatidylcholine(LPC).Methods The ratio of adhesion of monocytes and endothelial cells was assessed by measuring protein content.The expression of ICAM-1 and P-selectin in endothelial cells was examined by enzyme-linked immunosorbent assay(ELISA).Intracellular pH of endothelial cells was measured with 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein(BCECF).Results The results showed that LPC enhanced the adhesion of monocytes and endothelial cells in a concentration-dependant and time-related manner.The dosage of 5,10 and 20 ?mol?L-1 Cariporide reduced the adhesive ratio of endothelial cells induced by LPC(5 mg?L-1)from 36% to 23%,18% and 16%(P

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Humans ; Needles ; Pelvic Bones ; anatomy & histology

Objective To analyze the relation between the CT changes of ventricular volume and prognosis in newborn of perinatal hypoxic-ischemic brain damage.Methods From Jan. 2002 to Dec. 2006, 105 newborns with perinatal hypoxic-ischemic brain damage (moderate to severe) were divided into 2 groups (group A with nervous system sequel and group B without nervous system sequal). Brain CT was performed in 24 hours after admission in all cases and at 1 and 3-month time point in some cases according to their convalescence condition. Huckman index,the third ventricular width on CT images of various time points were measured and calculated by radiologist. The relations between the values and prognosis were analyzed statistically.Results The huckman index increased gradually with rehabil (P

Objective To explore the variance of helicobacter pylori(Hp) infection rate in children with recurrent abdominal pain(RAP).Methods By using the()~(13)C-urea breath test(~(13)C-UBT) to detect the status of Hp infection in 1676 children with RAP from 1998 to 2004.Results 1.Total 1676 cases of children with RAP were detected.There were 438 cases showed Hp positive,the positive rate was 26.13%.The infection rates in patients from 2-5,5-10,and 10-14 years of age were 23.66%(84/355),(26.31%)(286/1087),29.06%(68/234),respectively.2.Hp infection rates in children with RAP from 1998 to 2004 were 29.33%(83/283),(28.90%)(76/263),25.76%(51/198),26.01%(56/215),25.81%(48/186),24.45%(67/274),22.18%(57/257),respectively.Conclusion 1.The Hp infection rate in children with RAP increased with age;2.The Hp infection rate in children with RAP decreased year after year.

Objective To explore the right timing of mechanical ventilation in patients with bronchial asthma in emergency room.Methods A total of 67 patients with bronchial asthma undergoing mechanical ventilation were admitted into our Emergency Intensive Care Unit (EICU) from January 2010 to December 2012.According to PaCO2 before intubation,they were divided into 3 groups of low levels of PaCO2 [PaCO2 ≤35 mmHg (1 mmHg =0.133 kPa)] (n =19),normal PaCO2 (35 mmHg ＜ PaCO2 ＜ 45 mmHg) (n =21) and high PaCO2 (PaCO2 ≥ 45 mmHg) (n =27).Their clinical data were retrospectively analyzed.Results The in-hospital mortality of three groups were 5.3％ (1/19),9.5％ (2/21) and 14.8％ (4/27) and the difference was not statistically significant (x2 =1.16,P ＞ 0.05).However the average duration of mechanical ventilation of three groups were (5.6 ± 1.7),(8.3 ± 2.1) and (13.5 ±3.6) days and the difference was statistically significant (F =3.36,P =0.042).The average ICU treatment time was (7.4 ± 2.1),(11.5 ± 3.3) and (16.4 ± 3.5) days and the difference was statistically significant (F =3.23,P =0.047).PaCO2 levels before intubation was positively correlated with the duration of mechanical ventilation and the ICU treatment time (r2 =0.366,0.316,P =0.031,0.029).Conclusion The patients with bronchial asthma undergoing intubation in right time in emergency room will affect the duration of mechanical ventilation and ICU treatment time.

Using two fresh upper limbs of adult, the ABS casts of the fine vasculature about the skin, superficial and deep fascia of thenar and hypothenar were studied by scanning electron microscopy. The microvessel networks contained five layers, that is, (1) the papillary: the capillary loops aligned with the skin-print; (2) the subpapillary; (3) the profund corium: capillaries of the glomus bodies were visible; (4) the superficial fascia: the meshwork being leaf-like; (5) the profund fascia: mainly the line vessels. There is no difference about the morphologic construction of the microvessel networks between the left and the right hand, and between thenar and hypothenar.

Articular cartilage injury is a problem in the field of orthopedics,osteochondral allografis transplantation is an effective way in the treatment of articular cartilage injuries.The article summarizes the research advances of osteochondral allograft transplantation,including the indication and contraindication of the methods,currently application in clinical treatment,and further exploring three hot topics in the osteochondral allograft transplantation,such as the spread of diseases,immune rejection and graft preservation.These literature review showed that osteochondral allograft transplantation to repair cartilage damage has a specific advantage,but still has some problems for further promoting.

OBJECTIVETo study the results of arthroscopic partial meniscectomy for medial meniscal tear in late middle-aged adults.

METHODSFrom October 2010 to October 2012,49 patients meeting inclusion criteria were treated with arthroscopic partial meniscectomy for medial meniscal tear. There were 31 males and 18 females,with an average age of (55.3±2.8) years old. There were 22 left knees and 27 right knees. The average flexion angle was (116.01±12.03)°. The pre-operative HSS Knee Score was 48.73±8.43, and the Lysholm score was 63.95±5.45. The patients were followed up and evaluated. All the patients received a standard surgery, in which the torn tissue was removed, and the anterior part of the meniscus was left in situ.

RESULTSAll the surgeries were successful with no serious complications. All the patients were followed up,and the duration ranged from 12 to 36 months. All the patients had 5 degrees of muscle strength. The average flexion angle was (136.77±18.56)°. There was significant difference between the two angles before operation and after operation. The pre-operative HSS Knee Score was 90.17±4.10, and the Lysholm score was 87.84±5.16. Statistically, the difference between preoperative score and the postoperative score was significant.

CONCLUSIONArthroscopic partial meniscectomy is a good option for medial meniscal tear in late middle-aged adults. Operative indication is crucial and the excellent surgical technique is also critical for the good clinical outcome. All the patients could get good clinical results, although there are some patients with motion restrictions in the early stage after operation.

Arthroscopy ; methods ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Menisci, Tibial ; physiopathology ; surgery ; Middle Aged ; Tibial Meniscus Injuries

Adult ; Female ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Translocation, Genetic