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.

AIM:To evaluate 23G vitrectomy for macular edema in eyes with retinal vein occlusion (RVO) combined with vitreoretinal traction (VMT) or epiretinal membrane (ERM).METHODS:Totally 22 patients (22 eyes) diagnosed with macular edema of RVO combined with VMT or ERM were retrospectively analyzed.Twelve cases performed with 23G vitrectomy together with peeling of inner limiting membrane (ILM) and/or ERM were considered as the observation group or intervention group.Ten cases without vitrectomy were recruited as control group.The best corrected visual acuity (BCVA) and central retinal thickness (CRT) at baseline, 1, 3 and 6mo were recorded and compared.RESULTS:At baseline, the difference of BCVA and CRT between observation group and control group was not statistically significant (P=0.645, 0.206).After vitrectomy, the BCVA and CRT of RVO patients in observation group were significantly improved compared with baseline at each follow-up (F=2.895, P=0.048;F=16.431, P<0.01).However, the BCVA and CRT in control group remained the same as baseline at every follow-up.Moreover, the BCVA and CRT in observation group were much better than that in control group at both 3 and 6mo after vitrectomy.However, the BCVA and CRT between two groups were not significantly different at 1mo postoperatively.CONCLUSION:The 23G vitrectomy could markedly improve BCVA and reduce CRT in RVO patients with macular edema combined with VMT and/or ERM.

?AIM: To retrospectively analyze the surgical strategies and outcome of traumatic lens dislocation.?METHODS: Retrospective study. Clinical data of 105 cases ( 105 eyes ) diagnosed with traumatic lens dislocation from April to June 2014 in our hospital were recruited. According to position of dislocated lens and complicated situations, different surgical approaches were performed, including intracapsular lens extraction, phacoemulsification, vitrectomy through pars plana and lensectomy. Meanwhile, vitreo-retinal or anti-glaucoma surgeries were performed in complicated cases. Preoperative and postoperative LogMar ( Logarithm of the Minimum Angle of Resolution ) visual acuity were compared by paired t-test. Perioperative complications including expulsive choroidal hemorrhages and recurrent retinal detachment were recorded and assessed.?RESULTS: All 105 dislocated lenses were removed completely. Visual acuity of 91 eyes ( 86. 7%) were significantly improved postoperatively. The visual acuity of most patients was 0. 1-0. 3 ( 42 eyes, 40. 0%) and 1 patient’s visual acuity with lens subluxation reached more than 0. 8 postoperatively. Expulsive choroidal hemorrhages occurred in 1 eye intraoperatively and 1 eye postoperatively. Recurrent retinal detachment was observed in 2 eyes postoperatively.? CONCLUSION: According to position of the lens dislocation, personalized surgery strategy is critical for therapy of traumatic lens dislocation. Expulsive choroidal hemorrhage is one of most several complications and should be managed properly.

Objective To explore the change of activin A(ACT A) in umbilical artery blood of newborns with fetal distress and its clinical significance.Methods Forty healthy pregnant women(control group)and 35 pregnant women with fetal distress (experimental group)were collected.The levels of ACT A of umbilical artery blood in both groups were determined by a solid quantitative biotin-avidin system enzyme-linked immunosorbent assay(BAS-ELISA),umbilical artery blood gas were also measured.Results The level of ACT A of umbilical artery blood in fetal distress group was (1 235.89?178.78)ng/L,and that in control group was (627.28?75.24)ng/L,and the level of ACT A of umbilical artery blood in fetal distress group was significantly higher than that in control group(P

Objective To compare the differences and consistency of three criteria of metabolic syndrome(MS)including the third Report of the Adult Treatment Panel Ⅲ of National Cholesterol Education Program(NCEP-ATPⅢ),Chinese Diabetes Society(CDS)and International Diabetes Federation(IDF)used for evaluating in children and adolescents.Methods Four hundred and thirty-two overweight or obesity children and adolescents from Chuansha district of Pudong New Area of Shanghai were selected.Data of investigation of the risk factors of cardiovascular disease were reviewed.Anthropometric measurements and fast plasma glucose(FPG),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and dynamic blood pressure monitoring were performed.MS were identified according to NCEP-ATPⅢ criteria modified by Cook,CDS criteria modified by Liang,and IDF criteria,respectively.The consistency of the 3 criteria were studied.Results The number of subjects who met the criteria of MS were 31.0%,9.5% and 25.7% using Cook,Liang and IDF criteria,respectively.The conformity rate between Cook and Liang,Cook and IDF,Liang and IDF were 78.5%,89.1% and 83.8%,and the Kappa value were 0.378 20,0.719 18 and 0.465 37,respectively.Conclusions There are differences in consistency among the 3 criteria of MS.The agreement in the diagnosis of MS using Cook and IDF definition is higher than using Liang and other 2 definitions.The number of subjects who met the Cook criteria of MS is the most.The Cook definition may be more suitable for MS diagnosis in children and adolescents.A high conformity rate between Cook and and IDF criterion is proved.It is necessary to work out a universally accepted criterion adapted to children and adolescents.

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

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.

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.