Objective To investigate the therapeutic effect and safety of the intratracheal instillation of sodium nitroprusside for treating persistent pulmonary hypertension of newborn (PPHN) .Methods The intratracheal instillation of sodium nitroprusside was used to 19 cases of PPHN under the mechanical ventilation ,and the pulmonary arterial mean pressure(PAMP) ,arterial mean pressure(AMP) ,transcutaneous oxygen saturation(TcSaO2 ) of the right upper and left lower limb at the basic state ,30 ,60 ,120min after intratracheal instillation of sodium nitroprusside were respectively measured and compared .Results Among 19 cases of PPHN ,17 cases had the primary lung disease .Of 17 cases ,14 cases(82 .35% ) had significant decrease of PAMP after intratracheal instillation of sodium nitroprusside ,which was most significant at 30min after therapy and the difference was statistically significant compared with before therapy [(21 .30 ± 4 .200)mm Hg vs .(30 .30 ± 4 .20)mm Hg ,P<0 .05] ,but AMP between before and after therapy had no statistical difference [(56 .00 ± 3 .00)mm Hg vs .(55 .00 ± 6 .00)mm Hg ,P>0 .05] .Conclusion The intratracheal instillation of sodium nitroprusside is the safe ,effective and economic method for treating PPHN .

Objective Perioperative fluid therapy has always been the most basic and important measure to maintain the stability of patients'cyclic system.Colloid and crystalloid,as common perioperative fluid,play different roles in clinical application due to the different molecular sizes.In the recent years,besides their contribution to maintain the stability of cyclic system,scientists have begun to pay attention to the effect on coagulation,especially their comparison.This paper mainly discusses the study status of the influence on coagulation produced by different liquids.

Books ; Language ; Linguistics ; Medicine, Chinese Traditional ; Translations

Objective To investigate the expression of thymidylate synthase (TS) in bladder urothelial carcinoma(BUC) and its clinical significance, and to evaluate its prognostic value, thus to help predict the prognosis and choose therapy protocal. Methods The expression of TS was assessed by immunohistochemistry in 54 BUC and 15 normal bladder specimens, and all these clinical data were retrospectively analyzed after surgery. Expression of TS,clinicopathologic findings and two prognostic variances (relapse-free survival (RFS) and overall survival (OS)) were determined. The prognostic value of TS was estimated by survival curve and Cox proportional hazards model. Results Immunohistochemistry showed that 25 of 54 BUC cases (46. 30%) had high TS expression. In these cases,there was 29. 41%o (5/17) for G1 ,46. 43% (13/28) for G2,77. 78% (7/9) for G3 ;21.43% (3/14) for Ta, 26. 32% (5/19) for T1, 86. 67% ( 13/15 ) for T2,66.67% (2/3) for T3,66.67% (2/3) for T4. Expression of TS was positively associated with the grade and stage of carcinorma ( Kruskal - Wallis H, P = 0. 0 3 and P ＜ 0. 0 0 1 ). The recurrence and case - fatality of patients with high TS expression was 60. 00% (15/25) and 44. 00% (11/25) ,respectively. The survival analysis and Cox regression analysis showed that expression of TS were independent predictor for recurrence ( RR = 2. 65,95% CI was 0.80～8.81,P＜0.05) anddeath (RR=1.42,95%CIwas0. 36～5.58,P＜0. 05). Conclusions The probability of BUC progress and recurrence increases with the increasing of TS expression. Detection of TS expressing level can contribute to select appropriate treatment and follow-up schema.

Objective To customize the optimal plans for radioactive 125I seeds volumetric implants in selected regular target volumes.Methods 125I seeds were symmetrically and uniformly implanted into 3 spherical targets with the diameters of 1,2 and 3 cm and 7 ellipsoidal targets with the 3 dimensions of 1 cm×1 cm×2 cm,1 cm×1 cm×3 cm,1 cm×2cm×2cm,1 cm×2 cm×3 cm,1 cm ×3 cm×3 cm,2 cm×2 cm×3 cm and2 cm×3 cm×3 cm.The activity and inter-space of seeds were adjusted to obtain the conformal and uniform dose distribution,with the prescribed D90 (the dose delivered to 90％ of the targets) greater than 145 Gy.The inter-space of seeds was changed from 1 cm to 0.75 cm,to improve the conformity and uniformity of dose distribution.Plan quality was assessed using homogeneity index (HI),external index (EI) and conformal index (CI).The activity and number of seeds implanted were also recorded and compared.Results For the spherical target with the diameter of 1 cm,when seeds were implanted with the inter-space of 1 cm and 0.75 cm,the HI were 40.0％ and 55.9％,the EI were 98.3％ and 95.1％,the CI were 0.44 and 0.44,respectively.For the spherical target with the diameter of 3 cm and the target with the 3 dimensions of 1 cm × 2 cm × 2 cm,the implant with the inter-space of 1 cm provided better indices of HI,EI and CI than those with the inter-space of 0.75 cm.For the other targets,the implants with the inter-space of 0.75 cm provided better indices of EI and CI than those with the inter-space of 1 cm,although they displayed a little worse homogeneity in terms of HI.The activity per seed was 17.0-27.8 MBq and 30.0-58.8 MBq in the implants with the inter-spaces of 0.75 cm and 1 cm,respectively.2-10 more seeds were needed in the implants with the inter-space of 0.75 cm.Conclusions For the studied targets except the spherical targets with the diameter of 1 cm and 3 cm and the ellipsoidal target with the dimension of 1 cm × 2 cm × 2 cm,125I seeds implanted with the inter-space of 0.75 cm could provide more conformal dose distribution.It could be the better customized plans for uniformly spaced seed implantation.

Objective To investigate the influencing factors of cognitive impairment in patients with lacunar infarction (LI) and to analyze the features of cognitive impairment at different parts in patients with LI.Methods Patients with LI and normal controls were enrolled in the study.Mini-Mental Status Examination (MMSE) was used to evaluate cognitive impairment.California Verbal Learning Test (CVLT),Verbal Fluency Test (VFT),Benton Judgment of Line Orientation Test (BJLOT),Digit Symbol-Coding subtest (DSCT),Paced Auditory Serial Addition Test (PASAT),and Wisconsin Card Sorting Test (WCST)were used to evaluate attention,information processing speed,memory,verbal fluency,and executive function.Results A total of 98 patients with LI and 20 normal controls were enrolled.Of the 98 patients with LI,31 had cognitive impairment and 67 were cognitively normal.The proportions of hypertension,diabetes,multiple LI,and severe white matter lesions,as well as the level of low-density lipoprotein cholesterol in the CI group were significantly higher than those in the normal controls (all P ＜ 0.05).Multivariate logistic regression analysis showed that hypertension (odds ratio [OR] 5.391,95％ confidence interval [CI] 1.515-19.182; P=0.009),diabetes (OR 4.679,95％ CI 1.428-15.339; P=0.011),multiple LI (OR 6.458,95％ CI 1.797-23.213; P =0.004),and severe white matter lesions (OR 6.724,95％ CI 1.440-27.331; P=0.014) were the independent risk factors for the occurrence of cognitive impairment in patients with LI.Among the 98 patients with LI,56 were pure LI (no white matter lesions),but 5 of them were excluded because they could not complete neuropsychological tests.Finally,51 patients were enrolled and were compared and analyzed with the normal control group.Compared to the normal control group,the number of correct answers of WCST-64 in the corona radiata/semi-oval center group (n =15) reduced significantly,and the number of sustained errors increased significantly (P ＜ 0.05).The scores of verbal fluency,DSCT,PASAT,as well as the number of correct answers and the number of completed categories of WCST-64 decreased significantly in the basal ganglia group (n =20) (all P ＜0.05).The scores of short-term memory and delayed recall,as well as the scores of DSCT and PASAT decreased significantly in the thalamus group (n =16) (all P ＜0.05).Conelusiuns Hypertension,diabetes,multiple LI,and severe white matter lesions are the independent risk factors for occurring cognitive impairment in patients with LI.The corona radiata/semi-oval center infarction is easy to complicate with impaired executive function.Basal ganglia infarction is associated with verbal fluency,information processing speed,attention,and executive function impairment.The cognitive impairment of thalamic infarction is mainly manifested in the memory,attention,and information processing speed.

Objective To investigate the cytotoxic effects of differentiated PC12 cells afterinfected by prion protein 106-126 peptide.Methods The PC12 cells were infected by prion protein 106-126peptide after differentiated by nerve growthfactor(NGF).Cell viability andthe morphological changes were observed.The energy metabolize and apoptosis was detected.Results Afterinfected by this peptide,cell viability decreasedfrom(98.1±1.9)% to (69.2±4.7)%,and apoptosis peak Was observed byflow cytometry.Aboutthe process of the cytotoxic effects,afterthe cells affected by PrP106-126,oxidative stress presented and existed continually,and then the intracellular free calcium concentrate increased from (185.74±12.93)nmol/L to (493.00±58.71)nmol/L subsequently,the activity of Ca2+ ATPase decreased from 54.92±4.05 to 34.92±4.86,the mitochondrial membrane potential decreasedto 65%,and also the energy metabolize disorder,the cells presented apoptosisinthe end.The changed Bcl-2/Bax system involvedinthe apoptosis.Conclusions Prion protein106-126 peptide caninduce apoptosisin differentiated PC12 cells and presented cellulartoxicity definitely.It might be a perfect model to study the cellular toxicity of prion protein.Continual oxidative stress could causetheintracellularfree calcium concentrate and disturb the energy metabolize,and the apoptosis might be the end-result.The oxidative stress of might play a startup and important role.

Objective To explore the effect of swallowing training on dysphagia in patients with head and neck neoplasm receiving ra-diotherapy. Methods 60 patients with head and neck neoplasm receiving radiotherapy from March, 2014 to August, 2015 were divided into intervention group (n=30) and control group (n=30) randomly. The control group received routine nursing and relevant health education, while the intervention group received swallowing training from 2 weeks before to 3 months after radiotherapy. They were assessed with Functional Oral Intake Scale and M. D. Anderson Dysphagia Inventory 1 week, 3 months after radiotherapy. Results The scores of Function-al Oral Intake Scale (Z=-3.195, P<0.01), the total score of M. D. Anderson Dysphagia Inventory and the subscores (t>4.385, P<0.01) were better in the intervention group than in the control group 1 week after radiotherapy, as well as 3 months after radiotherapy (Z=-4.436, P<0.01;t>5.361, P<0.01). Conclusion Swallowing training could improve the condition of dysphagia of head and neck neoplasm patients after radiotherapy.

Radiotherapy is the primary treatment modality for nasopharyngeal carcinoma(NPC) which can effectively control the disease.Oral cavity,anatomically near nasopharyngeal region is the main area for the occurrence of complication of radiotherapy.Second primary malignancy (SPM) in oral cavity is an important factor interferencing NPC patients survival rate.The etiology of oral SPM is unclear and,the prognosis is poor.The research of it is still in exploration.

Objective To explore the surgical methods and clinical applications of single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury.Methods From October 2011 to October 2013,using single operation hole for thorascopic surgery treating encapsulated effusion with atelectasis in 56 cases after thoracic injury,35 males and 21 females,aged 21-68,mean 34 years old.The left encapsulated effusion with atelectasis in 31 cases,the right of encapsulated effusion with atelectasis in 25 cases,atelectasis in 43 cases,partial atelectasis in 9 cases,total atelectasis in 4 cases.Before thorascopic surgery,routine thoracentesis or (and) closed thoracic drainage were performed,but ineffective.Surgical approach for anesthesia with the thorascopic surgery encapsulated effusion dissection + suction drum lung surgery.Thorascopic surgery were completed in single operation hole,postoperative chest tube into the hole from observation.Results The operation time was 55-120 min,average 75 min; blood loss was 25-150 ml,average 65 ml.All patients underwent in single operation hole.The postoperative hospital stay was 7-19 d,average 11.2 d.There were no perioperative mortality and major complications.Conclusions The single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury is exactly effective and simple.It can be used as an effective treatment.