Objective To observe the effects of nose-stuffy continuous positive airway pressure(CPAP)combined with large-dose Mucosolvan on the hyaline membrane disease of newborn(NHMD). Methods Third),divided into three equal parts,by intravenous drop infusion]. According to the results of SpO2 and blood gas analysis,the CPAP setting was adjusted. Before and after the treatment,the SpO2、RR、PaO2、PaCO2、SaO2 of all the children were analyzed. Results Ten children of all(76.9%) were cured,two died,one quitThe SpO2 of the total,at one hour after the treatment,improved significantly(P＜0.001);the RR、PaO2、SaO2 at 24 hours later also improved(P＜0.05). Conclusion The method of nose-stuffy continuous positive airway pressure(CPAP) combined with large-dose Mucosolvan,which had good effects on ameliorating the symptom and improving the gas exchange,is worth used in primary hospitals widely.

Objective To study the validity of continuous positive airway pressure(CPAP)curing overlap syndrome.Methods Comparisons were made in the respiratory disturbance index(RDI)the longest apnea time the longest hypopnea time etc between before and after-treatment.Results The respiratory disturbance index(RDI)、the longest apnea time、the longest hypopnea time were signifi- candy different(P＜0.05).Conclusion Continuous positive airway pressure is an effective method to treat overlap syndrome.

Objective To observe the effect of salmeterol/flutieasone propionate on children with asthma. Methods Salmeterol/flutieasone propionate inhalation of different dosages were given according to different illness condition of asthma. Investigate the effects of 180 days inhalation of SM/FP among children. Results After 180 days' treatment, the PEFam and PEFpm of those children of asthma were significantly increased. The lung function has a perceptible improvement. In addition, the daytime and noctural symptom scores and asthma symptom were improved. Moreover, the shore-acting β2 agonist was used with decreasing frequency. The effects of SM/FP inhalation were marvelous after 1 week of treatment and should make a long persisting time alter six months of treatment. Conclusion SM/FP is an effective medicine for children with asthma and should be make more widespread.

OBJECTIVE:To study the improvement effects of baicalein against myocardial ischemia/reperfusion(I/R)injury in rats. METHODS:I/R injury model was induced by Langendorff method. Isolated heart of 40 rats were randomly divided into nor-mal group(continuous perfusion),model group(perfusion withdrawal 20 min)and baicalein high,medium and low concentration groups (K-H solution of baicalein 40,10 and 2.5 μmol/ml 10 min before perfusion withdrawal). The myocardial infarction rate, the activity of creatine kinase(CK)and lactate dehydrogenase(LDH)in coronary effluent liquid,SOD activity and MDA content, GSH/GSSG and apoptosis rate of cardiac muscle cell in myocardial tissue were detected. RESULTS:Compared with normal group, the myocardial infarction rate,apoptosis rate of cardiac muscle cell,the activities of CK and LDH and the content of MDA in myo-cardial tissue were increased in model group,while SOD activity and GSH/GSSG of myocardial tissue decreased(P<0.01). Com-pared with model group,the isolated myocardial infarction rate and the activities of CK and LDH in baicalein low and medium con-centration groups decreased,while SOD activity increased(P<0.05 or P<0.01);apoptosis rate of cardiac muscle cell and the con-tent MDA of myocardial tissue decreased significantly in medium concentration group,while GSH/GSSG increased (P<0.05 or P<0.01);those indicators had no significant change in high concentration group(P>0.05). CONCLUSIONS:Baicalein has cer-tain improvement effect on myocardial I/R injury in rats,and its mechanism may be associated with antioxidant and anti-apoptosis effect of baicalein.

Objective To discuss the feasibility and value of routine clinical preoperative examination predicting benign and malignant thyroid nodules. Methods The clinical data of 1630 patients undergoing thyroidectomy for nodular thyroid disease were analyzed retrospectively.The relationship between pathological diagnosis and physical examination,ultrasonographic parameters,the results of laboratory test and nuclear medicine test were examined to build a risk prediction model.The sensitivity,specificity and accuracy of the formula were tested. Results In 387 cystic nodules 0.78％ were malignant; In 1243 solid nodules 17.2％ were malignant.Among the 1243 cases,characters significantly related to malignancy were:age younger than 40 years,solitary lobe involvement,hypoechoic nodule,irregular margins,solid nodule,microcalcification,macrocalcification,max diameter ≤ 2 cm. The prediction formula was: malignancy indicator =0.80 × age + 0.59 × solitary lobe + 0.72 × hypoechoic + 0.82 × irregular margin + 1.32 × solid nodule + 1.90 × microcalcification + 0.70 × macrocalcification + 0.71 × max diameter.The threshold limit value was 2.8,and the sensitivity,specificity and accuracy of which were 74.4％,80.4％ and 75.2％,respectively. Conclusions Benign and malignant thyroid nodules could be differentiated roughly with the combination of patients' general information and the results of routine examination before operation.

Objective To evaluate the accuracy of an expiratory resistance device assisting pulse pressure variation (PPV) in predicting volume responsiveness in the spontaneously breathing patients.Methods Forty spontaneously breathing patients of both sexes,aged 22-61 yr,weighing 51-73 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation,were enrolled.Before induction of anesthesia,mean arterial pressure (MAP),heart rate (HR),central venous pressure (CVP),cardiac index (CI) and pulse pressure variation (PPVB) were recorded after haemodynamics were stable.Then the expiratory resistance device was used,and MAP,HR,CVP,CI,and PPVA were recorded.The device was then removed.Volume expansion was carried out.6％ hydroxyethyl starch 130/0.4 6 ml/kg was infused over 10 min.MAP,HR,CVP,CI and PPVB were recorded within 3 min after volume expansion.The device was used again,and 1 min later MAP,HR,CVP,CI and PPVA were recorded.The device was then removed.The patients were divided into 2 groups according the percentage of increase in CI after volume expansion (△ CI):△ CI≥ 15％ considered to be a positive response group (group P),and ACI＜15％ considered to be a negative response group (group N).A receiver-operating characteristic (ROC) curve for PPV was plotted.According to the ROC curve,the diagnostic threshold,sensitivity,specificity,area under the curve,and 95％ confidence interval of the expiratory resistance device assisting PPV in predicting volume responsiveness were determined.Results The area under the curve (95％ confidence interval) of PPVA was 0.880 (0.70-0.98),the diagnostic threshold was 13.5％,and the sensitivity and specificity in determining volume responsiveness were 87％ and 88％,respectively.Compared with the value before administration of the loading dose,the CVP and CI were significantly increased,and PPVB and PPVA were decreased after volume expansion in group P,and the CVP and CI were significantly increased after volume expansion in group N (P＜0.05).Compared with group P,the PPVA was significantly decreased before volume expansion,and the CI was increased after volume expansion in group N (P＜0.05).Conclusion The expiratory resistance device can assist PPV in predicting volume responsiveness in the spontaneously breathing patients.

Objective To observe the therapeutic effects of the parenchymal malignancies treated with argon-helium cryoablation percutaneouslly.Methods 49 foci in 45 patients with malignancies were treated with argon-helium cryoablation percutaneouslly.The temperature in the cryoablated area was dynamically recorded.The size and coverage of ice-balls formed were monitored.The imaging changes were observed.The shrinkage of tumor was followed 3 months post-cryoablation.The foci were divided into two groups in size:less than or equal to 3 cm and more than 3 cm.The chi-square test and spearman analysis were used by SPASS 11.0 software.Results The temperature in the cryoablated area descended fast to below-130℃ in a minute and relatively kept maintaince about-150℃ or so in the whole procedure.It ascended to 15℃ in a minute after rewarming.The ice-balls were formed within 50 seconds after cryoablation in 87.5% foci.And it increased in size as the time going.The coverages of the iceball more than or equal to and less than 80% were 72.7%、27.3% and 26.3%、73.7% in groups of less than or equal to 3 cm and more than 3 cm,respectively(P＜0.05).The ice-ball was demonstrated as arc hyperechogenicity with shadow and round-like low density on sonography and CT imaging,respectively.The shrinkage more than 50%of the foci was 81.8% and 30.6% in the groups of less than or equal to and more than 3 cm three months after the cryoabalated procedure(P＜0.01).Conclusion It is an actual/exact and convient way for the pereutaneous argon-helium cryoablation in treating malignancy.It can be used in the management of the parenchymal malignancy whole body.

Objective To investigate the prognostic significance of follicular lymphoma international prognostic index (FLIPI) and FLIPI2 in Chinese FL patients for better prognostic model.Methods 63 newly diagnosed FL patients who received rituximab plus CHOP (cyclophosphamide,doxorubicin,vincristine and prednisone)-like chemotherapy from January 2003 to December 2010 were retrospectively analyzed according to FLIPI and FLIPI2 scoring system.Results According to FLIPI,31 patients (49.2 ％) were stratified into the low risk group (0-1 point),24 (38.1％) into the intermediate risk group (2 points),and 8 (12.7 ％) into the high risk group (3-5 points).As for FLIPI2 scoring,17 cases (27.0 ％) were classified in low risk group (0 point),42 cases (68.3 ％) in intermediate risk group (1-2 points),and 4 cases in high risk group (3-5 points).The overall response rates and 2-year progression free survival (PFS) rates of the three risk groups were 93.5 ％ (29/31),91.7 ％ (22/24),75.0 ％ (6/8) (P =0.27),and 85.7 ％,75.2 ％,58.8 ％ (Log-rank =1.063,P =0.59) respectively in FLIPI.In terms of FLIPI2,the overall response rates and 2-year PFS rates of the three groups were 100.0 ％ (17/17),90.7 ％ (39/42),50.0 ％ (2/4) (P =0.01) and 92.9 ％,74.0 ％,33.3 ％ (Log-rank =7.075,P =0.03).Conclusion FLIPI2 presents more robust prognostic significance than FLIPI in disease progression perspective for FL patients treated with R-CHOP like regimens in this study.

Objective To investigate the effect of microcireulation blood flow and altering immunity by Chuanxiongqin,ulinastain and thymosin α1 on sepsis patients.Methods 90 patients were randomly divided into 3 groups(n=30),namely ICU group,Chuanxiongqin group,ulinastain and thymosin α1 group.HLA-DR/CD14+and IL-6,TNF-α,Lac,DD were measured.Results (1)DD showed no significant difference at every time point between ICU group and ulinastain+thymosin α1 group(P＞0.05).DD decreased in Chuanxiongqin group,and was significantly different from the others on the third day.(2)Lac unchanged significantly at every time point in ICU group(P＞0.05).Lac in Chuanxiongqin group and ulinastain+thymeain α1 group tended to decrease,and was statistically different from ICU group on the second day.(3)IL-6 and TNF-α tended to increase at every time point in ICU group(P＜0.05).In ulinastain+thymosin α1 group,IL-6 and TNF-α returned to the level before treatment,HLA-DR/(D14+increased significantly,and was higher than Chuanxiongqin group and ICU group statistically.Conclusion Chuanxiongqin could ameliorate circulation;ulinastsin and thymosin α1 could depress IL-6,TNF-α.So ulinastain and thymosin α1 might protect the immunity of sepsis patients.

Background and purpose:The prognostic capability of traditional prognostic index like follicular lymphoma international prognostic index (FLIPI) is limited in the rituximab era. This study was to investigate the prognostic significance of peripheral blood absolute lymphocyte count/absolute monocyte count (ALC/AMC) in Chinese patients with follicular lymphoma (FL).Methods:This study retrospectively analyzed 136 newly diagnosed FL patients who received rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP)-like chemotherapy in Department of Hematology, Ruijin Hospital from Jan. 2003 to Dec. 2013, and further classified these patients according to FLIPI scoring system.Results:According to FLIPI, 61 patients (44.9%) were stratified into the low-risk (0-1 points) group, 42 cases (30.9%) into the intermediate-risk (2 points) group, and 33 cases (24.2%) into the high-risk (3-5 points) group. The overall response rate and 2-year progression-free survival (PFS) of the 3 risk groups were 88.5%, 95.2%, and 78.8% (P=0.090), and 91.4%, 74.6%, and 47.8% (log-rank=23.3,P<0.001), respectively. The overall response rate and 2-year PFS for patients with ALC/AMC≥4.7 and <4.7 were 91.9%, 68.6% (P=0.005) and 96.0%, 69.7% (log-rank=13.0,P<0.001), respectively. In the multivariate study, ALC/AMC≥4.7 was independent of FLIPI and was able to distinguish the FLIPI low-risk and intermediate-risk patients (log-rank=7.535,P=0.006).Conclusion:For FL patients treated with R-CHOP-like regimens, ALC/AMC is a simple and effective biomarker reflecting tumor microenvironment and human immunity, and could be considered for prognosis evaluation.