Adult ; Aged ; Aged, 80 and over ; Humans ; Middle Aged ; Noninvasive Ventilation ; Nutritional Support ; Pneumoconiosis ; complications ; therapy ; Positive-Pressure Respiration ; Respiratory Insufficiency ; etiology ; therapy ; Retrospective Studies

Objective: To investigate the stamina,the role of antioxidant system in severe acute pancreatitis(SAP),and the effect of fish oil treatment in rats.Methods:Thirty-six male Sprague-Dawley rats(SD) were randomly divided into three groups,including SAP group(sodium chloride treatment ) (group NSG,n=12),fish oil treatment group (group FOG,n=12),and control group (group CG,n=12).SAP was induced by intergraded injection of 3.5% sodium tanrocholate to biliopancreatic duct of SD rats in group NSG and FOG.The group NSG rats were treated by subcutaneous injection of sodium chloride,while the group FOG rats were treated by subcutaneous injection of fish oil for 7 days.Then the improved tail suspension test was observed at the first,third,fifth,seventh day.12 rats in each group were respectively sacrificed after 7 day.The activity of serum antioxidant enzymes (MDA,GSH-PH) and the concentration of serum amylase were measured in each group,and the levels of threshold on the area and the total immobility time were measured in each group.The severity of pancreatitis was analyzed according to the histopathological morphology.Results: Compared to group NSG,the severity of pancreatitis was significantly decreased in group FOG.The activity of MDA was significantly increased in group NSG than that in group CG (P<0.01) ,while the activity of MDA in group FOG was decreased than that in group NSG (P<0.05) .The activity of GSH-PH was significantly decreased in group NSG than that in group CG(P<0.01),while the activity of GSH-PH was increased in group GOG than that in group NSG (P<0.05).THE level of threshold on the area was decreased in group NSG than that in group CG(P<0.01),while the level of threshold on the area was increased in group GOG than that in group NSG.(P<0.01) The total immobility time was significantly increased in group NSG than that in group CG(P<0.01),while the total immobility time was decreased in group GOG than that in group NSG(P<0.05).MDA was associated with the level of threshold on the area and the total immobility time.Conclusion: Fish oil has a positive effect on the activity of antioxidant system and behavior character in SAP rats.

A stable and reliable infected necrotizing pancreatitis (INP) model in rats was established in order to study the pathophysiological mechanism and pathological development rule of INP and explore the new therapeutic methods for the diseases. Forty-six SD rats were randomly divided into 5 groups. The animals in group A received the injection of 5% sodium taurocholate into the pancreatic duct and those in group B underwent that of E. coli into the pancreatic duct. The rats in groups C, D and E were subjected to the injection of 5% sodium taurocholate in combination with different concentrations of E. coli (10(3), 10(4), 10(5)/mL, respectively) into the pancreatic duct. The dose of injection was 0.1 mL/100 g and the velocity of injection was 0.2 mL/min in all the 5 groups. Eight h after the injection, the survival rate of animals was recorded and the surviving rats were killed to determine the serum content of amylase and perform pathological examination and germ cultivation of the pancreatic tissue. The results showed that acute necrotizing pancreatitis model was induced by injection of 5% sodium taurocholate into the pancreatic duct. The positive rate of germ cultivation in group A was 12.5%. The acute necrotizing pancreatitis model was not induced by injection of E. coli into the pancreatic duct and the positive rate of germ cultivation in group B was 0. The INP model was established in groups C to E. The positive rate of germ cultivation was 60%, 100% and 100% and 8-h survival rate 100%, 100% and 70% in groups C, D and E, respectively. It was concluded that a stable and reliable model of INP was established by injection of 5% sodium taurocholate in combination with 10(4)/mL E. coli into the pancreatic duct with a dose of 0.1 mL/100 g and a velocity of 0.2 mL/min. The pathogenesis of INP might be that the hemorrhage and necrosis of pancreatic tissue induced by sodium taurocholate results in weakness of pancreatic tissue in fighting against the germs. Meanwhile, the necrotic pancreatic tissue provides a good proliferative environment for the germs.
Cholagogues and Choleretics/*pharmacology ; Disease Models, Animal ; Escherichia coli/*metabolism ; Injections, Intraperitoneal ; Pancreas/enzymology ; Pancreas/microbiology ; Pancreatic Ducts/enzymology ; Pancreatic Ducts/microbiology ; Pancreatitis, Acute Necrotizing/*chemically induced ; Pancreatitis, Acute Necrotizing/*microbiology ; Rats, Sprague-Dawley ; Taurocholic Acid/*pharmacology ; Time Factors

Objective To study the clinical application value of long term home noninvasive positive pressure ventilation in the therapy of silicosis patients with type 2 respiratory failure. Methods A total of 85 silicosis patients with type 2 respiratory failure were enrolled, and their clinical data were retrospectively analyzed. According to the therapeutic method, they were divided into noninvasive positive pressure ventilation group (group A) and basic therapy group (group B). The various indicators of the patients were analyzed before and after the treatment including vital signs, laboratory indicators, 6-minute walking distance (6MWD), and modified dyspnea index (mMRC). The admission times, length of hospital stay and annual mortality of the patients were also recorded by follow-up after the treatment for one year. Results After the one year follow-up, the heart rate, respiratory rate, PaO2, PaCO2, SO2％, 6MWD, and mMRC of group A were significantly improved than those of group B (all P<0.05). The admission times and the length of hospital stay of group A were lower than those group B (all P<0.05). There was no difference in the annual mortality between the two groups (P>0.05). Conclusions The therapeutic method of home noninvasive positive pressure ventilation has significant effects on silicosis combined with type 2 respiratory failure. It can improve clinical symptoms and the quality of life, and reduce the length of hospital stay and admission times, and reduced medical insurance burden.

cleaning and disinfection.Results All 28 surveyed medical institutions had separate endoscope disinfection rooms, 89.29% of which had integrated endoscopic cleaning station,17.86% had automatic endoscope washer/disinfector;100% used multi-enzymatic detergent,chose the right disinfectant,monitored disinfectant concentration every day, and implemented standard disinfection time.But only 39.29% changed multi-enzymatic detergent for each endo-scope,cleaning and disinfection personnel in 78.57% of medical institutions wore personal protective equipment correctly.77 digestive endoscopes were detected,the qualified rate was 88.31%.Conclusion Cleaning and disin-fection management of digestive endoscope in secondary and above medical institutions in Suzhou City is generally standardized,there are still some problems in the manipulation procedures,relevant national regulations should be strictly complied with,efficacy of cleaning and disinfection of digestive endoscope should be further improved.

Objective To explore the clinical therapeutic effect of inverted DHS and PFNA in the treatment of femoral intertrochanteric fractures. Methods A total of 97 patients with intertrochanteric fracture in our hospital from Mar. 2011 to Mar 2013 in the department of orthopaedics were randomly divided into two groups. 48 cases were included into DHS group,another 49 cases were included into PFNA group.And then the perioperative index and the average healing time,postoperative fracture reduction loss, the excellent rate of joint function recovery and the incidence of complications between the two groups were compared. Results Theoperative time,intra-operative blood loss,postopera-tive drainage,the average healing time of PFNA group were better than that in DHS group (P<0.05).The postoperative fracture reduction loss,complication incidence of PFNA group was significantly lower than that in DHS group,and the excellent rate of joint function recovery of PFNA group was significantly higher than that in DHS group (P<0.05). Conclusion PFNA is a reliable and effective therapy for femoral intertrochanteric fractures,it is of worthy of clinical application.

A stable and reliable infected necrotizing pancreatitis (INP) model in rats was established in order to study the pathophysiological mechanism and pathological development rule of INP and explore the new therapeutic methods for the diseases. Forty-six SD rats were randomly divided into 5 groups. The animals in group A received the injection of 5% sodium taurocholate into the pancreatic duct and those in group B underwent that of E. Coli into the pancreatic duct. The rats in groups C, D and E were subjected to the injection of 5% sodium tanrocholate in combination with different con-centrations of E. Coli (103, 104, 105/mL, respectively) into the pancreatic duct. The dose of injection was 0.1 mL/100 g and the velocity of injection was 0.2 mL/min in all the 5 groups. Eight h after the injection, the survival rate of animals was recorded and the surviving rats were killed to determine the serum content of amylase and perform pathological examination and germ cultivation of the pancre-atic tissue. The results showed that acute necrotizing panereatitis model was induced by injection of 5% sodium taurocholate into the pancreatic duct. The positive rate of germ cultivation in group A was 12.5%. The acute necrotizing pancreatitis model was not induced by injection of E. Coli into the pan-creatic duct and the positive rate of germ cultivation in group B was 0. The INP model was estab-lished in groups C to E. The positive rate of germ cultivation was 60%, 100% and 100% and 8-h sur-vival rate 100%, 100% and 70% in groups C, D and E, respectively. It was concluded that a stable and reliable model of INP was established by injection of 5% sodium taurocholate in combination with 104/mL E. Coli into the pancreatic duct with a dose of 0.1 mL/100 g and a velocity of 0.2 mL/min. The pathogenesis of INP might he that the hemorrhage and necrosis of pancreatic tissue in-duced by sodium taurocholate results in weakness of pancreatic tissue in fighting against the germs.Meanwhile, the necrotic pancreatic tissue provides a good proliferative environment for the germs.

Objective:To investigate the effect of lateral tibial periosteum distraction on diabetic foot and vasculitis foot.Methods:A retrospective analysis of 13 patients (16 feet) who received lateral tibial periosteal distraction between June 2019 and May 2020 were included in the study. 9 males and 4 females; aged 39-77 years (average 66 years); left foot 7 cases, right foot 9 cases. 5 cases were patients with diabetic foot, 1 case was diabetic foot with arteriosclerosis obliterans, 2 cases were thromboembolic vasculitis, and 5 cases were arteriosclerosis obliterans. The tibial periosteum was dissected and a distraction device was placed. In the 3 patients with foot ulcers, tibial periosteum distraction devices were placed on the severer side. The periosteal distraction began on the third day after surgery, about 0.75 mm/d, the adjustment was done usually in two weeks. Two weeks later, the stretch plate was removed surgically. The followings were evaluated: visual analogue scale (VAS) pain score, foot peripheral oxygen saturation, foot capillary filling test, lower extremity arterial CT angiography (CTA), etc.Results:All 13 patients were followed up for 2-12 weeks, with an average of 3.85 weeks. VAS pain score: the average pain score of 13 patients with preoperative foot pain was 5.31±1.84 (range, 2-9) points, and 2 weeks after surgery, the average value was 2.46±1.39 (range, 1-6) points with statistical significance ( t=6.124, P<0.001) ; peripheral foot oxygen saturation: the average preoperative blood oxygen saturation of 12 patients was 87.83%±14.83% (range, 50%-98%), 1 patient was not detected before surgery, and 2 weeks after operation, the average blood oxygen saturation was 92.33%±7.91% (range, 75%-99%). There was no significant difference between them ( t=1.124, P=0.285). The foot skin temperature of 10 patients was 35.68±0.85 ℃ (range, 34.00-36.60 ℃) before surgery and 36.23±0.46 ℃ (range, 35.50-36.90 ℃) after surgery, and the difference was statistically significant ( t=3.197, P=0.008) . Capillary filling test: 2 weeks after operation, the capillary filling response was significantly improved. All 13 patients had improved CTA of both lower extremity arteries before operation, and 11 patients had CTA taken back after two weeks of operation. Compared with preoperative CTA, new vascular network was found in the operation limb. In addition to 1 patient with thromboangiitis obliterans (mainly suffering from foot pain, no wound symptoms), 2 of 12 patients with heart failure, renal failure and other basic diseases did not heal, and the wounds of the other 10 patients had improved significantly 1 month later. Conclusion:Lateral tibia periosteum distraction can be used to treat chronic ischemic diseases of lower extremities with satisfactory postoperative results.