Bilateral lung lavage was performed under general anesthesia with muscle relaxation in 3 patients with pulmonary alveolar proteinosis(PAP)aged 43-57 yrs weighing 48-68 kg.Left lung lavage was performed first and the right lung was lavaged one week later.Left radial artery and right internal jugular vein were cannulated for MAP,HR and CVP monitoring.SpO_2 and P_(ET) CO_2 were monitored during lavage.Left-sided Robertshaw double-lumen tube was used for both right and left lung lavage.After proper placement of the double- lumen tube was verified both lungs were ventilated with 100% O_2 for 10 min to wash out N_2.Hyperoxygenated lavage fluid was made by aerating the lactated Ringer's solution with 100% O_2 at 1 L?min~(-1) flow rate for 30 seconds.The tidal aliquot of lavage was 700 ml which was kept in the lung for 50 seconds and then drained.Each lung was lavaged with hyperoxygenated and plain lactated Ringer's solution 10 times each alternatively.While one lung was being lavaged the contralateral lung was mechanically ventilated with 100% O_2.SpO_2,MAP,HR,CVP and P_(ET)CO_2 were recorded immediately before lavage and at 10,20,30,40,50,60,70 and 80 seconds after the lung was filled with lavage fluid.SpO_2 was significantly higher during lavage with hyperoxygenated fluid than with ordinary lactated Ringer's solution,but there was no significant difference in MAP,HR,CVP and P_(ET)CO_2.The PaO_2 of the 3 patients breathing room air was 46-52 mm Hg before lung lavage and increased to(72.3?2.1) mm Hg one week after left lung lavage and to(83.5?4.8)mm Hg 3d after right lung lavage.During the lung lavage,hyperoxygenic significantly improve oxygen supply in patients with pulmonary alveolar proteinosis compared with lactated Ringer's solution.

This study was aimed to optimize the near infrared (NIR) variable selection method based on multivariate detection limit (MDL). Using Qing-Kai-Ling (QKL) injection as object, three variable selection methods (interval par-tial least-squares, iPLS; backward interval partial least squares, BiPLS; moving window interval partial least squares, mwPLS) were used to establish the PLS models of baicalin in QKL injection, respectively. The prediction ability of different variable selection method was compared. MDL of all models were calculated in contrast to the MDL value of full spectra PLS model, to select optimal variable selection method. The results showed that different variable selec-tion methods had different prediction ability. Among them, iPLS had the best performance which determination coef-ficient of prediction (Rpre2) and the root mean square errors of prediction (SEP) were 0.996 5 and 602.3 μg·mL-1, re-spectively. All MDLs of different variable selection methods were reduced compared with the full spectra PLS model. The value of iPLS was the lowest comes to be 1.19 μg·mL-1. The results above indicated that the best variable se-lection method for baicalin in QKL injection was iPLS. MDL theory took the error of calibration and validation set and the leverage of external sample into account, which can comprehensively evaluate model detection performance compared to the classic chemical indicator parameters. This method was particularly suitable for the variable selec-tion method optimization of NIR quantitative model of low concentration sample such as Chinese herbal medicine.

Objective To study the effect of a novel injectable scaffold material chitosan- beta-TCP combining bone marrow mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) on repairing bone defect of goat. Methods The model of the studies was 12ram diameter circular hole tibia bone defect of goat. 30 Chinese goats were raudomly divided into 5 groups: blank group: nothing was embeded in bone defect; simple material group: the material embeded in bone defect was chitosan-beta-TCP; PRP group: the material was chitesan-beta-TCP combining PRP; MSCs group: the material was chitosan-beta-TCP combining MSCs; PRP/MSCs group:the material was chitosan-beta-TCP combining MSCs and PRP. At 4,8 weeks after operation, the samples were observed, histological and image analysis were used to evaluate the effect of bone regeneration. Results At 8 weeks, the surface of bone defect zone of PRP/MSCs group were coverd by continuous new bones, like normal bone. Histological slice showed the esteoid at boundary of normal bone of MSCs/PRP group obviously increased compare to other groups at the 4th or 8th week after operation respectively. The new bone tissues of bone defect were punctiform or lamellar new bone tissues, in which the proportion of big lamellar new bone tissue obviously increased. Image analysis showed that the areas of balnk group, simple material group, PRP group, MSCs group, PRP/MSCs group were 8.79±3.63,14.49± 3.72,24.18 ± 5.38,24.42 ± 5.10,31.10 ± 3.49 at 4 weeks and 15.41 ± 4.21,25.36 ± 5.37,30.71 ± 4.39, 33.97 ± 4.45,48.60 ± 5.97 at 8 weeks respectively. The effect of bone regeneration of PRP/MSCs group was better than other groups (P < 0.05). Conclusion The injectable tissue-engineering bone constructed with chitosan-beta-TCP, MSCs and PRP possesses good ability on repairing bone defect.

Objective To explore the effect of cutaneous never anastomosis on sensory recovery in repairing wide spreadly soft tissue defects in dorsal hand with free anterolateral femoral flap. Methods The cases with wide spreadly soft tissue defects in dorsal hand repaired with free anterolateral femoral flap from January 2006 to December 2012 were divided into 2 groups. The control group including 15 consecutive patients from January 2006 to January 2009, whose sensation was reconstructed in routine way. Other 15 consecutive patients from Febnary 2009 to December 2012 were as research group, whose sensation was reconstructed with the suture of cutaneous nevers of anterolateral femoral flaps and forearm. All the patients were followed up for 12~24 months. Results All the free flaps survived in both groups. There were 4 cases good of sensory recovery in the control group, and it was 11 in the research group. No ulceration happened. Conclusion Cutaneous never anastomosis may result in satisfactory sensory function in the patients with wide spreadly soft tissue descts in dorsal hand repaired with free anterolateral femoral flap.

Objective To study the effect of small doses of furosemide combined with brain natriuretic peptide for treatment of contrast -induced nephropathy.Methods A total of 180 patients of coronary an-giography or ( and ) percutaneous coronary intervention were recruited and divided into trial group ( n =90 ) and the control group ( n =90 ) . Patients in control group were given postoperative intravenous 20 mg of furosemide, patients in trial group were given the injection of furosemide combined with brain natriuretic peptide. Renal function indexes ( concentration of serum creatinine, serum creatinine clearance and glomerular filtration rate) after operation 48 h were observed, and the in-cidence of contrast-induced nephropathy was compared between the two groups.Results After surgery, serum creatinine concentration of control group was (82.01 ±15.12) μmol·L-1 , which significantly higher than that of the trial group of (73.92 ±16.79) μmol·L-1;serum creatinine clearance of control group was ( 86.84 ±22.11 ) mL·min-1 and glomerular filtration rate was ( 83.78 ±16.69 ) mL/( 1.73 m2·min ) , all lower than those of trial group of ( 96.83 ±24.51 ) mL·min -1 and (96.95 ±21.22) mL/(1.73 m2·min).The incidence of contrast-in-duced nephropathy in trial group was 5.56%, which significantly lower than that of control group ( 24.44%, P <0.05 ) .Conclusion For the treatment of contrast-induced nephropathy, small doses of furosemide combined with brain natriuretic peptide can effectively improve the patient' s kidney function and prevent the happening of the contrast-induced nephropathy.

Objective To study the correlation between the negative mood and social support in patients undergoing heart valve replacement and to seek corresponding nursing strategies.Methods Self-ratingAnxiety Scale(SAS),Self-rating Depression Scale(SDS),Social Support Rating Scale(SSRS)were used to assess the effectiveness of psychological intervention and social support intervention.Results The anxiety and depression of cardiac valve replacement group were significantly higher than the normal control group (P<0.05) and their social support for the factor score and total score were lower than the control group (P<0.05).In addition,anxiety,depression and social support was negatively correlated(P<0.05)and after nursing intervention,the patients'anxiety,depression score and social support total score were significantly improved(P<0.05).Conclusions The cardiac valve replacement patients with anxiety and depression are obvious and their social support is low.Negative psychology and social support are closely related.Psychological intervention can improve the effect of care.

Objective:To explore the prophylactic efficiency of dexmedetomidine on postoperative nausea and vomiting (PONV) in highly susceptible patients.Methods:By using randomized and double-blind controlled trial, 100 non-smoking female patients receiving laparoscopic surgery were selected and randomly divided into dexmedetomidine group and control group.The dexmedetomidine group received 0.6 μg/kg dexmedetomidine before induction, and 3 μg/kg dexmedetomidine after surgery.The severity of PONV, the visual analogue scale (VAS)for pain scores, the use of rescued antiemetic and analgesic drugs were assessed for 48 h postoperatively.Results:There were 93 patients completed the study (47 cases in dexmedetomidine group and 46 cases in control group).The number of patients classified as PONV 0 in dexmedetomidine group was significantly more than that in the control group during the time interval 0 to 6 h postoperatively (37 vs 27, P<0.05).The percentage of the usage of antiemetic drugs within 48 hours in dexmedetomidine group was lower than that in control group(25.5% vs 47.8%,P<0.05).During the time intervals 6 to 24 h and 24 to 48 h, the pain scores were significantly lower in dexmedetomidine group compared with control group, 2.9±0.9 vs 3.4±0.7 and 2.7±0.6 vs 3.0±0.7, respectively (P<0.05).Conclusions:Dexmedetomidine used perioperatively might decrease the severity of PONV in early phase postoperatively in highly susceptible patients, and reduce the need for antiemetic drugs and improve the analgesia effects.

Objective To confirm the distribution of high arsenic drinking water and the situation of endemic arsenism in Hubei Province, to provide reference basis for prevention and control of endemic arsenic disease. Methods Using typical investigation and sample investigation in 2006 and 2007, the arsenic content of water was detected sampled from 19 counties(cities or communities). And those water samples which were close to or exceeded the stipulated standard were rechecked by the national standard method. Furthermore, the situation of endemic arsenism was investigated in the cities having high arsenic contents of water. Results In 2006,10 028 water samples of 446 villages in 6 counties (cities or communities) were tested, the wells of high arsenic (> 0.05 mg/L) were found in 5 counties (cities or communities) and the proportion of the well that exceeded stipulated standard was 5.29%(530/10 028); In 2007,19 086 water samples of 1282 villages in 17 counties(cities or communities) were tested, the wells of high arsenic were found in 11 counties(cities or communities), and the proportion of the well that exceeded stipulated standard was 1.74%(333/19 086). In these two years, 29 114 water samples were tested, in which 863 water samples were exceeding the stipulated standard. The 2.96% of total wells exceeded stipulated standard and mainly distributed in 179 villages of 12 counties(cities or communities). And the highest arsenic content of water sample was 2.012 mg/L. In the endemic arsenism area, 2 critical, 1 moderate and 1 mild arsenism patients had been found. Conclusions The water of high arsenic content are scattered in Hubei Province and the situation of endemic arsenism disease is mild. Improving water aiming at decreasing arsenic and establishing patient files should be carried out immediately.

Aged ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; Multiple Endocrine Neoplasia Type 2b ; Neuroma ; pathology ; Pharyngeal Neoplasms ; pathology