Objective To study the clinical application of proportional assisted ventilation (PAV) in the treatment of neonatal respiratory failure.Method From March 2011 to October 2013,a retrospective study was conducted on newborns receiving ventilation therapy for respiratory failure.The newborns were assigned into PAV group and synchronized intermittent mandatory ventilation (SIMV) group.Arterial blood pH 、partial pressure of arterial oxygen (PaO2)、partial pressure of arterial carbon dioxide (PaCO2) and oxygenation index (OI) were compared at the time before ventilation and 2 h,6 h,12 h,24 h after ventilation.The frequency of sedative usage and average time of ventilation between the two groups were compared.Result A total of 30 cases were enrolled in the PAV group and the SIMV group respectively.Before ventilation,no statically significant differences existed on blood pH[(7.13 ± 0.12)、(7.14 ±0.11)],PaO2[(41.1 ±8.9),(40.8±8.8) mmHg],PaCO2[(76.4±12.6),(73.2±13.5) mmHg]and OI between the two groups (P ＞ 0.05).2 h after ventilation,the blood pH [(7.25 ± 0.17)、(7.23 ± 0.15)],PaO2 [(51.0 ± 5.6)、(48.6 ± 5.3) mmHg] and OI were significantly improved,while PaCO2 [(66.3 ± 8.7)、(64.0 ± 7.5) mmHg] decreased.Comparing with data before ventilation,those parameters were statistically improved at each time point after ventilation (P ＜ 0.01).But no statistically differences existed between the two groups at the same time (P ＞ 0.05).Sedatives were used (2.3 ± 1.2)times/case in PAV group and (3.9 ± 2.2) in SIMV group,with statistically differences between the two groups (P ＜ 0.05).Average duration of ventilation were (5.1 ± 1.9) d in PAV group and (5.4 ± 2.1) d in SIMV group,with no statistically differences between the two groups (P ＞ 0.05).Conclusion PAV is very effective in treating the neonatal respiratory failure and worth spreading.

BACKGROUND:With the development of industry and agriculture, organotin compounds have been widely used in China. Organotin compounds cause a common occupational poisoning. The toxicity of organotin was reported in animal studies; however the reports about human organotin intoxication are very rare. In this study we retrospectively analyzed the clinical manifestations of 15 organotin-poisoned patients who had been treated at our hospital from 2002 through 2007. METHODS:Fifteen patients with organotin poisoning were admitted to Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from 2002 to 2007. They were 9 males and 6 females, aged from 25 to 52 years. Clinical manifestations and Glasgow Coma Scales showed that the poisoning was mild in 4 patients, moderate in 6 and severe in 5. The severe patients were given glucocorticoid after hospitalization by intravenous guttae of 500 mg methylprednisolone for the first day, followed by 160 mg methylprednisolone per day for three days, and then 80 mg methylprednisolone per day for another three days. Potassium glutamate and sodium glutamate were intravenously dripped to reduce blood ammonia; intravenous guttae plus oral administration of potassium 9 g/day was used to correct intractable hypokalemia; sodium bicarbonate was used to correct metabolic acidosis, and sedatives were used to control spasm and twitch; mechanical ventilators were used in 4 patients with dyspnea. RESULTS:Most of the patients showed elevated level of blood ammonia, decreased level of blood potassium and metabolic acidosis, but some had demyelination changes shown by CT and MRI. Treatments included correction of metabolic acids, blood potassium and ammonia, and mechanical ventilation when necessary. For patients with injuries of the nervous system, glucocorticoids were given immediately after hospitalization. These patients showed intractable hypokalemia and metabolic acidosis during the treatment. Forteen patients recovered completely without long-term side-effect. One patient in the aphasiac stage restored the linguistic capacity during a 6-month follow-up. CONCLUSIONS:Elevated level of blood ammonia, decresed level of blood potassium, and metabolic acidosis are common in patients with organotin poisoning. Demyelination can be observed in patients with severe poisoning. The abnormalities of the patients are reversible after suitable treatments.

Objective To establish a mouse model of lymph node metastasis of breast cancer cells by luciferase imaging assay,to monitor early process of lymph node metastasis,and to evaluate the effect of X-ray radiation therapy on tumor.Methods The mouse mammary cancer cell line 4T1-Luc expressing luciferase was inoculated subcutaneously into the paw pad of nude mice to establish a model of subcutaneous lymph node metastasis.The lymph node metastasis in nude mice was continuously observed by in vivo fluorescence imaging system,and the nude mice with early lymph node metastasis of breast cancer cells were divided into control group and treatment group randomly.The radiotherapy effect was observed by in vivo fluorescence imaging system and evaluated by the pathological changes of HE staining of tumor tissue.Results A mouse lymph node metastasis model of breast cancer cells was successfully established,and the volume of primary tumor in paw correlated with the fluorescence photon number positively (r =0.958,P ＜ 0.001).On the twenty-fourth day after inoculation,the fluorescence photon number in pad tumor and popliteal fossa tumor of treatment group were significantly decreased in comparison with the control group (t =32.58,P ＜ 0.05),and the inhibition ratio of radiotherapy on tumor growth approached to 85 ％.HE staining showed that the apoptosis and necrosis in irradiated tumor was obviously higher than that in control group.Conclusions Bioluminescence imaging technique can be used to evaluate the effect of X-ray on breast cancer suppression and lymph node metastasis in mice.

Objective To investigate the appropriate compatibility of appropriate compatibility of sevoflurane and propofol for patients with mild cognitive impairment (MCI) undergoing posterior lumbar interbody fusion in order to protect their cognitive function.Methods Eighty patients, 41 males, 39 females, aged 65-75 years, BMI 17-26 kg/m2, ASA physical status Ⅰ or Ⅱ, scheduled to undergo elective posterior lumbar interbody fusion, were to be scored according to Montreal cognitive assessment (MoCA), mini mental state examination (MMSE), dementia scale (CDR) and daily living ability scale (ADL) to identify patients with MCI before the surgery.They were randomly assigned to 4 groups (n=20 each) using a random number table: TCI propofol 2.0-2.5 μg/ml group (group P), TCI propofol 1.2 μg/ml+sevoflurane 0.6 MAC group (group PS1), TCI propofol 0.6 μg/ml+sevoflurane 0.9 MAC group (group PS2), 1.0-1.5 MAC sevoflurane group (group S).MoCA and MMSE were used to evaluate the cognitive function of patients 1 d before the operation (T0), after patients become wide-awake (T1), 3 d and 7 d after operation (T2 and T3).Apolipoprotein J (ApoJ) concentration related to cognitive function in blood samples, which were drawn at T0-T3 would be measured with ELISA method.Results Compared with T0, the scores of MMSE and MoCA in four groups decreased significantly (P＜0.05) at T1, the scores of MMSE and MoCA in group S decreased significantly (P＜0.05) at T2;compared with T1, the score of MMSE in the four groups increased significantly at T2, T3 (P＜0.05).The scores of MMSE at T1, T3 in group S decreased significantly compared with groups P, PS1 and PS2 (P＜0.05).The scores of MoCA at T2, T3 in group S decreased significantly compared with groups P, PS1 and PS2 (P＜0.05).Compared with T0, the concentration of plasma ApoJ in the four groups increased significantly at T1 (P＜0.05).Compared with T1, the concentration of plasma ApoJ in the four groups decreased significantly at T2 and T3 (P＜0.05).Compared with group PS1, the concentration of plasma ApoJ at T1, T3 increased significantly in groups S and group PS2 (P＜0.05).Conclusion TCI propofol 1.2 μg/ml combined with 0.6 MAC sevoflurane group is the appropriate compatibility of sevoflurane and propofol for patients with MCI undergoing posterior lumbar interbody fusion,because it has less negative influence on cognitive function and lower concentration of plasma ApoJ.

BACKGROUND: The permeability of blood-retinal barrier in rats can be increased due to the exposure under infrasound. There is rare research on ionic mechanism of such damage to barrier because of lacking the sources of retinal microvascular endothelial cells.OBJECTIVE: To investigate the impact of infrasound on calcium-activated potassium channel(BKca) of bovine retinal microvascular endothelial cells (BRECs).DESIGN: A completely randomized controlled opening study.SETTING and MATERIALS: The research was conducted in the Laboratory for patch-clamp, Department of Clinical Aerospace Medicine, Fourth Military Medical University of Chinese PLA. Experimental subjects were BRECs cultured.INTERVENTIONS: The cultured BRECs were exposed to the infrasound of 8 Hz, 130 dB for 30 minutes.MAIN OUTCOME MEASURES: The activity of BKCa in BRECs was observed.RESULTS: The activity of BKCa channel in BRECs increased after the exposure of infrasound of 8 Hz, 130 dB for 30 minutes. BRECs were cultured in an incubation cabin for 30 minutes after exposure for another detection by patch-clamp ionic current, and the increased BKCa channel activity slightly decresed.CONCLUSION: The breakdown of blood-retinal barrier under infrasound is partly due to the stimulatory effect of infrasound on Ca2 +-activated-K +channel, which will cause membranous depolarization providing the driving force of Ca2+ influx on BRECs.

Objective To develop and test a stressor scale for in-patients with spinal cord injury (SSIPSCI). Methods Based on in-depth interviews and the second-level International Classification of Functioning, Disability, and Health (ICF) categories, a 39-item SSIPSCI was generated and pilot tested. It was then used with 284 inpatients with spinal cord injury. Principal components factor analysis and correlation analysis were performed.Results The exploratory components factor analysis revealed 7 significant stress factors: social activity, economy security, individual activity, relationship with others, physical disorders, bowel and bladder problems and medical fees. Internal consistency was high, with a Cronbach's alpha coefficient of 0. 950 overall and 0. 741 ～ 0. 920 for the individual factors. Test-retest reliability was 0.848. The correlation between SSIPSCI scores and Beck depression inventory (BDI) scores was strong ( r = 0. 665 ). Conclusions The reliability and validity of the SSIPSCI are both satisfactory enough to meet psychometric requirements.

A dispute about the decreasing-price problem of traditional Chinese medicine (TCM) has recently arisen. This article analyzes the statistical data of 1995-2011 in China, the results showed that the main responsibility of expensive health care has no direct relationship with the drug price. The price index of TCM rose significantly slower than the medicine prices, the production margins of TCM affected by the material prices has been diminishing since 1995, continuous price reduction will further depress profits of the TCM industry. Considering the pros and cons of raw materials vary greatly in price, decreasing medicine price behavior will force enterprises to use inferior materials in order to maintain corporate profits. The results have the guiding meaning to medicine price management.
Commerce ; economics ; Data Interpretation, Statistical ; Health Care Sector ; economics ; Humans ; Medicine, Chinese Traditional ; economics

Objective To observe the inhibitory effect of pyridoxine hydrochloride (PN) combined with common chemotherapeutics on mice hepatoma cells H22 in vitro. Methods MTT assay was used to determine the effects of PN in combination with 10 different antineoplastic agents on H22 cells, and immuno-histochemistry was used to observe the distribution of PN in H22 cells and morphologic changes of the cells before and after PN treatment. Results After 24 hours incubation with 5 mmol/L PN, the treated cells expanded apparently with nucleus chipping. PN entered the tumor cell and was mainly condensed in cytoplasma and H22 cells were sensitive to PN. When administered concomitantly with chemotherapic agents, most of the combinations showed antagonistic effects while a few of the combinations were additive. For instance, doxorubicin (ADM) used in combination with PN inhibited cell proliferation with an IR value (IR=0.63) much lower than ADM alone (IR=0.71, P<0.01), and the CI value was less than 0.9, which indicated an antagonistic effect. However, PN in combination with ifosfamide (ICTX) showed additive effect (CI>0.9), and the IR value (IR=0.60) in combined group was higher than that (IR=0.40) in ICTX group (P<0.05). Conclusion PN treatment could increase the intracellular PLP level and result in growth inhibition and cell death, and combined administration of PN and ICTX might be a potential method to improve efficacy and to reduce toxic effects while a co-administration of PN and ADM should be avoided.

Adolescent ; Adult ; Alprostadil ; pharmacology ; Anticoagulants ; pharmacology ; Child ; Child, Preschool ; Dextrans ; pharmacology ; Female ; Fibrinolytic Agents ; pharmacology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Heparin ; pharmacology ; Hepatic Veno-Occlusive Disease ; etiology ; prevention & control ; therapy ; Humans ; Infant ; Male ; Middle Aged ; Platelet Aggregation Inhibitors ; pharmacology ; Treatment Outcome

OBJECTIVETo study the distribution and antibiotic resistance of the isolated pathogens from children with infectious diarrhea in Guangzhou.

METHODSThe fecal samples of 2 409 children with infectious diarrhea between January 2006 and December 2007 were collected and cultured. Pathogenic bacterium were isolated and identified by biochemical and serological methods. The antibiotic susceptibilities were tested by the Kirby-Bauer method.

RESULTSA total of 448 isolates of pathogenic bacterium (18.6%) were obtained, including Shigella (n=159), enteropathogenic Escherichia coli (n=141), Salmonella (n=76), Vibrion (n=11), fungus (n=41), and C jejuni (n=20). All of isolates of the three major pathogenic bacterium, Shigella, enteropathogenic Escherichia coli and Salmonella, were susceptible to imipenem and less than 10% of the isolates were resistant to the third generation cephalosporins and beta-lactamase inhibitors. However, the isolates showed a high resistance to ampicillin and sulfamethoxazole/trimethoprim (>75%).

CONCLUSIONSShigella, enteropathogenic Escherichia coli and Salmonella were major pathogenic bacterium of diarrhea in children from Guangzhou. The major isolates were susceptible to imipenem, the third generation cephalosporins and beta -lactamase inhibitors, but were resistant to ampicillin and sulfamethoxazole/trimethoprim.

Adolescent ; Bacteria ; drug effects ; isolation & purification ; Child ; Child, Preschool ; Diarrhea ; drug therapy ; microbiology ; Drug Resistance, Microbial ; Female ; Fungi ; drug effects ; isolation & purification ; Humans ; Infant ; Male