Objective To evaluate the efficacy of manually controlled jet ventilation with Manujet Ⅲ apparatus (VBM Co, Germany) for removal of airway foreign body in children. Methods One hundred and twenty ASA Ⅰ or Ⅱ children aged 10 months-12 yr, weighing 8-35 kg undergoing removal of airway foreign body were randomly divided into 3 groups (n=40 each) : group Ⅰ spontaneous respiration (SR) ; group Ⅱ intermittentpositive pressure ventilation through the short side tube of the rigid bronchoscope (IPPV) and group Ⅲ manually controlled jet ventilation with Manujet Ⅲ (JV). Anesthesia was induced with methylprednisolone 2 mg/kg, propofol 2 mg/kg and γ-OH 70 mg/kg in group SR (Ⅰ) and with methylprednisolone 2 mg/kg, propofol 4-5 mg/kg, fentanyl 1.5 μg/kg and succinylcholine 2 mg/kg in group IPPV and JV (Ⅱ,Ⅲ). The bronchescope insertion condition, the occurrence of hypoxia during and after operation, body movement during operation, the rate of successful removal of the foreign body, the duration of operation, anesthesia emergence time and perioperative side effects were recorded. Resulls The rate of good bronchescope insertion condition and successful removal of airway foreign body were significantly higher, the rate of hypoxia during and after operation, body movement, breath holding and restlessness were significantly lower and duration of operation and anesthesia emergence time were significantly shorter in group IPPV and JV than in group SR (P<0.05). The rate of intraoperative hypoxia was significantly lower in group JV than in group IPPV (P<0.05). Conclusion Jet ventilation with Manujet Ⅲ can reduce the occurrence of hypoxia during removal of airway foreign body in children and does not interfere with the operation.

Objective To study the effects of bone marrow stromal cells derived neural stem cells on apoptosis and the expression of Bcl-2 and Bax after focal cerebral ischemia and reperfusion.Methods The model of middle cerebral artery occlusion (MCAO) and reperfusion was set up by Longa. Thirty-two Sprague-Dawley rats were divided into 4 groups: sham-operated group (A), ischemia control group (B), bone marrow stromal cells transplanted group (C) and bone marrow stromal cells derived neural stem cells transplanted group (D). The rats were killed on the day 7 and 14 after transplantation. The brain sections were used for terminal deoxynucleotidyl transferase dUTP mickend labeling (TUNEL) staining and Bcl-2, Bax immunohistochemical staining.Results The number of apoptotic cells in groups C and D was decreased as compared with that in group B on the day 7 and 14 after transplantation (P

Objective To investigate the relativity mechanism and clinical significance between the ST-T changes in electrocardiogram and cerebral apoplexy. Methods 2160 electrocardiogram materids of brain patients in our hospital for medical treatment were analyzed retrospectively. The clinical materials of 98 cases(contrast group) who had no obvious changes and 80 cases(observe group) who had obvious changes of ST-T in ECG were compared. Results 1327 cases of electrocardiographic presented abnormality of 2160, which accounted for 56. 97% of the unusual electrocardiogram. Compared with the contrast group, the incidence of hypertension, coronary heart disease, respiratory failure. electrolyte distur-rbances,beart expanding and mayn rinds of electrocardraphic abnormality was higher(P

Objective To investigate the effect and safety of the application of radiofrequency ablation(RFA) and ethanol injectionunder the different guidance means for105 patients with primary and metastatic hepatic cancer.Methods Aretrospective study was accom-plished on the radiofrequency ablation and ethanol injection for105 patients with primary and metastatic hepatic cancer under the guidance ofultrasound(56 cases),CT(12 cases),laparoscope(9 cases),open surgery(26 cases) and ultrasound associated with laparoscopic(2cases).Results The operations of RFA with the shortest time were guided by ultrasound(0.8?0.3) h,while the longest operations wereguided by open surgery(3.6?2.5) h(P

Objective To compare and observe the effect and side effect of two different kinds of simulation mode for nasopharyngeal carcinoma conventional radiotherapy. Methods 147 cases were randomly divided into the study group (74 cases, CT simulation) and the control group (73 cases, X-ray radiography simulation). In the study group three-dimensional treatment planning system (IPS) was used to draw target volume and organ at risk, and then beam eye view (BEV) function was utilized to design treatment plan and subsequent plan modulation. In the control group X-ray simulation radiography was used. Two groups of plan design and subsequent plan modulation mode were exactly the same, and the radiotherapy were performed on the same accelerator. Results For these two groups, there were 5-59 months follow-up. The recent therapeutic effect of nasopharyngeal carcinoma primary site and cervical lymph node metastasis was regular,and no statistical significance (P >0.05). For the study group 3-year local recurrence rate was 5.4 % (4/74) while the control group was 16.4 %(12/73), and there was obvious statistical significance between two groups. About one year and three year accumulated survival rate, the study group was 98.5 %, 77.4 %, and for the control group was 92.9 %, 64.7 %. Two groups survival curves were examined by Log-rank test: the survival curves showed statistical significance between two groups(P <0.05). In control group, stage II and III radiotheray reaction of oralis mucosa was significantly increased compared with that of the study group (P < 0.05). There were two cases radioactivity cerebral palsy and one case optic nerve damage in the control group, but no serious dermatosis, soft tissue fibrosis and radioactivity posterior cranial nerve damage. Conclusion The CT simulation which is applied to nasopharyngeal carcinoma conventional radiotheraphy could improve therapeutic effect and reduce cancer recurrence and radiation side effect.

ObjectiveTo explore the clinical features, treatment, and outcomes of tachycardia induced cardiomy-opathy (TIC) in children.MethodsThe clinical data of 20 children with TIC hospitalized from January 2007 to October 2014 were retrospectively analyzed.ResultsIn 20 patients with TIC, there were 11 infants, one toddler, 5 pre-school age children, and 3 adolescent patients were as follows: 15 cases of atrial tachycardia (distributed in each age group), 3 cases of paroxysmal supraventricular tachycardia (2 in infancy and one in adolescence), and 2 cases of ventricular tachycardia (2 in infancy). After the treatment of anti-arrhythmic drugs, sinus rhythm was restored in 11 patients and ventricular rate was controlled in 5 patients while poor effect of drug was found in one patient who received radiofrequency ablation eventually and got cured. Three patients received radiofrequency ablation after admission immediately. Compared with those before treatment, left ventricular ejection fraction (LVEF) and left ventricular diastolic diameter (LVDD) measured by cardiac ultrasonography were signiifcantly improved after treatment (P<0.01).ConclusionsTIC is common in infancy. Atrial tachycardia is the main type of arrhythmia. Generally drug therapy is the ifrst choice in the treatment of TIC but in older children and those refractory to drug therapy the radiofrequen-cy ablation is chosen.

Today pedicle screw instrumentation system and short-segment fixation have been commonly used for treatment of thoracolumbar burst fractures because pedicle screw fixation allows 3-column fixation and facilitates simultaneous application of axial compression or distraction and rotational forces.Indirect decompression and direct decompression are the two ways to deal with canal compromise when pedicle screw instrumentation is used.Indirect decompression is achieved to correct the canal compromise due to ligamentotaxis and hyperextension.The present study reviews the current research on indirect spinal canal decompression in adult patients with thoracolumbar burst fracture.

Objective To investigate the expression of Oct4 protein and analyze its correlation with the clinic pathological features and prognosis of non-muscle-invasive bladder cancer.Methods The oct4 protein expression was assessed by immunohistochemical analysis in 87 specimens of bladder transitional cell carcinoma and 15 specimens of adjacent normal tissues.A correlation between Oct4 and clinic pathological features was analyzed.Results The positive rate of Oct4 protein was significantly higher in bladder cancer than that in normal bladder tissue (P＜0.01).The positive rate of Oct4 protein was 40.7％ in G1 bladder cancer,69.4％ in G2 bladder cancer and 91.7％ in G3 bladder cancer,and the differences was significant (P＜0.01).All patients were followed up for 3-78 months,and 63 of them relapsed.The expression of Oct4 protein was significantly higher in patients of recurrence than in non-recurrence (77.8％ ∶ 37.5％,P ＜ 0.01 ).21 patients of recurrence were in progression,and the expression of Oct4 protein had no significant differences between patients of progression and non-progression (71.4％ ∶65.2％,P ＞0.05).The positive rate of Oct4 protein was not related with gender,age,tumor number and size (P ＞0.05).Conclusion The detection of Oct4 protein is in favor of early detection of bladder tunor,estimation the degree of differentiation and surveillance for recurrence of superficial bladder cancer.

Objective To investigate drug resistance,especially the resistance to aminoglycoside and the prevalence of the genes for aminoglycoside-modifying enzymes in Escherichia coli producing ESBLs.Methods VITEK-32 GNI+ cards and K-B methods were used to identify E.coli and detect the resistance to 18 kinds of antibiotics such as aminoglycoside and ?-lactams respectively in E.coli isolated from our hospital from January to December,2006.PCR method was used to detect the genes for aminoglycoside-modifying enzymes such as aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6')-Ⅰb,aac(6')-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ in those 17 strains producing ESBLs.Results Resistance rates were 100.0%,100.0%,41.6%,100.0%,69.5%,30.5%,98.2%,81.0%,81.0%,79.6%,79.2%,34.8%,15.4%,7.1%,7.9%,5.4% and 81.0% for ampicillin,ampicillin/sulbactam,aztreonam,cefazolin,cefepime,ceftazidime,ceftriaxone,ciprofloxacin,levofloxacin,gentamicin,tobramycin,amikacin,cifoxitin,nitrofurantoin,piperacillin/tazobactam,cefoperazone/sulbactam and co-trimoxazole respectively in E.coli producing ESBLs.No drug-resistant strain imepenem was found.Positive rate was 46.4% for ESBLs.Resistance rates were 52.9%(9/17),100.0%(17/17) and 100%(17/17) for amikacin,gentamycin and tobmycin respectively in those 17 strains producing ESBLs.The most genotype for aminoglycoside-modifying enzymes was aac(3)-Ⅱ(94.1%),the second was aac(6')-Ⅰb(35.3%).The positive rates of aac(3″)-Ⅰ and ant(2″)-Ⅰ were 11.8% and 5.9% respectively.of them,one strain was resistant to aminoglycoside on phenotype,but no genes mentioned above was detected.4strains were classical on genotype,one with aac(6')-Ⅰb-Cr,the other one with a new subtype among the 6 strains of E.coli with aac(6')-Ⅰb.Conclusions Drug resistance in E.coli is rather serious.Typically,E.coli producing ESBLs shows multi-drug resistance.Positive rate for aac(3)-Ⅱ takes the first place,followed by aac(6')-Ⅰb among the genes for aminoglycoside-modifying enzymes.Aac(3″)-Ⅰand ant(2″)-Ⅰ show both lower positive rates.Aac(3)-Ⅰ and aac(6')-Ⅱ were not found.There exist at least 3 sub-types of aac(6')-Ⅰb,one kind of gene for aminoglycoside-modifying enzymes in strains of E.coli.Among those sub-types,the classical type is the main,accompanied by aac(6')-Ⅰb-Cr and its new sub-type.

Objective To study the method and nursing measurements of the detection of portal venous pressure. Method The implantable drug delivery system was performed during the operation in 31 patients with liver cancer. The direct dynamic observation was performed by using the system and the corresponding nursing measurement was given. Result The measurement of portal venous pressure was successful performed 251 times in 31 cases with liver cancer and no complications were taken place. Conclusions The dynamic observation of portal venous of pressure by using the implantable drug delivery system was simple. Safety and could be repeated and could easily be receipted by the cases, the nurses skilled measured the key points of nursing and actively prevented the complications was taken implant role in increasing the rate of success of detection .