Objective To evaluate the effectiveness of noninvasive positive pressure ventilation(NPPV) as a weaning strategy in patients with acute respiratory failure after failure to wean from invasive positive pressure ventilation(IPPV). Method A prospective randomized and controlled clinical trial of weaning of IPPV was carried out in patients mechanically ventilated in mode of IPPV for more than 48 hours with failure in a spontaneous breathing trial(SBT: PSV 6 cmH_2O). Patients with contraindications to NPPV were excluded. After failure the SBT, patients were randomly divided(random number) in two groups. Patients in NPPV group were extubated after being ventilated with high pressure support for 30 minutes and then placed on NPPV. Patients in IPPV group were weaned following conventional procedure. Arterial blood gases, maximal inspiratory pressure, respiratory rate,tidal volume, rapid shallow breathing index, heart rate, arterial blood pressure, and peripheral oxygen saturation were measured before and after failing the SBT. The rate of complications, including pneumonia and tracheotomy duration mechanical ventilation, days of hospital stay and outcome were observed. Findings of the two groups were vompared using the Student t test and the chi-square test. Results The percentage of complications in the NPPV group was lower(22.9% versus 72.2%, P <0.01) ,with lower incidences of pneumonia(6.1%,36.1%; P <0.01) and tracheotomy. Compared between the two groups, days of ICU stay( 14.16(3.45) d vs. 22.57( 7.71 ) d; P <0.01) and total days of mechanical ventilation(14.88±3.76 days vs. 20.68± 2.79 days, P <0.01) of NPPV group are shorter than IPPV group. Conclusions NPPV is a good alternative to the mechanically venti-lated patients who fail in initial weaning attempts. The key to successful NPPV weaning is the proper selection of weaning candidates and using NPPV as soon as possible after extubation.

Objective To investigate the prognostic value of CD44V6, MMP-9, p57kip2 and hCG in diagnosis differential diagnosis and malignant transformation of hydatidiform mole. Methods The expressions of CD44V6 MMP-9 and p57kip2 was detected by SP method and the serum hCG was detected with CLIA method in 55 cases of hydatidiform mole, 20 cases of abortion villi and 10 cases of normal villi, and the value of CD44V6, MMP-9, p57kip2 and hCG in diagnosis differential diagnosis and malignant transformation of hydatidiform mole was analyzed. Results There were 9 cases malignant transforming hydatidiform mole and 44 cases of non-malignant transforming hydatidiform mole(20 cases of complete hydatidiform mole, 26 cases of partial hydatidiform mole). The expression of CD44V6 MMP-9 and p57kip2 of malignant transforming mole was significantly higher than that of non-malignant transforming group (77.8 % vs 30.4 %, 77.8 % vs 34.8 %, 11.1 % vs 58.7 %) (P <0.05) and the expression difference of p57kip2 in complete mole and partial mole group (5.0 % vs 100.0 %) was statistically significant (P <0.05). HCG remained positive in 4 cases of hydatidiform mole and dropping and then rised in 5 cases. The sensitivity of p57kip2 in the diagnosis of partial hydatidiform mole was 100.0 %, the specificity was 95.0 %, the negative prediction was 100.0 %. The sensitivity of CD44V6 in the diagnosis of malignant hydatidiform mole was 77.8 %, specificity was 69.6 %, negative prediction was 94.1 %;The sensitivity of MMP-9 was 77.8 %, specificity was 65.2 %, negative prediction was 93.8 %. The sensitivity of the two combined detection (CD44V6 and MMP-9) was 88.9 %, negative prediction was 96.3 %. The sensitivity of combined detection (CD44V6, MMP-9 and hCG) was higher than any of them. Conclusion p57kip2 is an important marker in differential diagnosis of hydatidiform mole. CD44V6, MMP-9 play important roles in the process of transformation of hydatidiform mole. The combined detection of CD44V6, MMP-9, p57kip2 and hCG can help to diagnosis and differential diagnosis and predict biological behaviors and prognosis of hydatidiform mole.

Objective To explore the reference values of peak expiratory flow (PEF) for 4.0-14.0 years old children in Chengdu.Methods From November 2011 to May 2012,a total of 446 healthy children were enrolled in this study.PEF was measured using expiratory peak velocimeter and lung function meter.Children's age,sex,height and weight were recorded.Impact factors for PEF were investigated by multiple stepwise regression analysis.Results The PEF detected by expiratory peak velocimeter and lung function meter had a good correlation (r =0.920,P ＜ 0.01).Boys own higher peak expiratory flow rate than girls.The level of PEF had the best correlation with height,next was weight and age.The level of PEF increased with the increase of height,age.Some children PEF value was less than 80％ lower limits of lower limits of normal.The PEF could be obtained from height and age.Conclusions Males and females PEF can be calculated according to children's height.Set up the PEF equation about the expiratory peak velocimeter and lung function meter.

Objective To investigate the effect of different intrathecal doses of meperidine on shivering during cesarean delivery under spinal-epidural anesthesia.Methods Sixty parturient women,ASA grade Ⅰ-Ⅱ grade,scheduled for cesarean delivery were enrolled in four groups by random digits table with 15 cases each group.All patients underwent combined spinal-epidural anesthesia.Spinal anesthesia consisted of isobaric bupivacaine 0.5％ (10 mg) in the standard group (group A),isobaric bupivacaine 0.5％ (10 mg) plus 5 mg meperidine in group B,isobaric bupivacaine 0.5％ (10 mg) plus 10 mg meperidine in group C,isobaric bupivacaine 0.5％(10 mg) plus 15 mg meperidine in group D.The signs and symptoms were recorded 10,20,30,60 min after anesthesia respectively.Results All patients were successfully operated,not unexpected.Four groups at each time point of vital signs,nausea and vomiting,and the number of cases of neonatal 1,5 min Apgar scores was no significant difference (P ＞ 0.05).Group A of shivering and the third grade shivering were significantly more than the number of group B,C,D(11 cases vs.2,1,1 cases;4 cases vs.0,0,0 cases,P＜ 0.01).Conclusion Epidural anesthesia,intrathecal meperidine 5-15 mg can effectively prevent shivering in cesarean section.

AIM: To determine the ultimate preservation time of murine cardiac grafts in 4℃ Ringer's solution. METHODS: Murine cardiac grafts were implanted to the abdominal vessels heterotopically 2, 4, 6, 8 and 10 hours after cold preservation. Graft survival rate and histological morphological changes, as well as the neutrilphil, T cell, macrophage infiltration, ICAM expression were determined by immunohistochemistry. RESULTS: The cardiac function-recovery rate and 1-week graft survival rate were 100% and 83.3% in 6-hour preservation group. Compared with non-preservation control group, no more apparent histological damages, cell infiltration and ICAM expression were found. CONCLUSION: The ultimate preservation time of murine cardiac graft in 4℃ Ringer's solution was 6 hours. [

Objective To investigate the correlation between bacterial cryptic growth cell(CGC)and irritable bowel syndrome(IBS).Methods The techniques of micro-culture and morphological observation were employed in examination of the CGC in feces specimens of patients suffering from IBS.Furthermore,the animal monitoring tests was applied in the aspects of CGC formation under inducing factors and colonization at local intestinal mucus.Results A great deal of CGC could be observed in the feces of IBS patients and exhibited continuous proliferation characteristics regardless of using or not using antibiotics.And the CGC in feces showed auto-lysis features when the patients suffered from the disease.The monitoring tests demonstrated that the antibiotics often used presently to IBS patients could induce the formation and colonization of intestinal bacterial CGC.Conclusion Based on the experimental and clinical data,we presume that there is a correlation between intestinal bacterial CGC and IBS.

OBJECTIVE To study the possibility of applying Anerdian skin disinfectant for blood donor skin disinfection. METHODS Put Anerdian at 21℃,35℃ and 42℃ to exposure in air for 24h,48h and 72 h,detect the volatilization volume,effective iodine and appearance of disinfectant,and evaluate its effect on blood donor elbow by culture method. RESULTS At 21℃ exposure for 24 h the volatilization rate for Anerdian was 5%,effective iodine was 0.215%.At 35℃ and 42℃ exposure for 24 h its volatilization rate was more than 5%,and effective iodine was within the range of 0.18-0.22%.The average killing logarithm value of elbow skin natural bacteria in 30 donors was over 1. CONCLUSIONS Anerdian disinfectant is suitable for blood donor predonation skin treatment.

To establish a bioassay method and quality standard of Banlangen granula, agglutinated activity assay was used in the analysis of the traditional Chinese medicine, Banlangen granula. It showed that masculined effect could be picked up effectively and the products quality of different pharmaceutical factories and different batch numbers from the same factory could be revealed conveniently, accurately, quickly and directly with this method (valence value was between 2 and 11). The established bioassay method had a good reproducibility with RSD = 2%. The dependablity of the activity of red cell agglutination and restrainting influenza virus NA was conspicuous (r2 = 0.878 3). In conclusion, this bioassay method is suitable to control and evaluate the quality of Banlangen granula. Thus the method may provide a simple and effective technique in supervising and examining the quality of other traditional Chinese medicine.

Objective To evaluate the imaging features of benign fibrous histiocytoma (BFH).Methods Imaging data were retrospectively collected and reviewed in 11 patients with pathologically proved BFH.Of the 11 patients,X-ray was performed in all patients,MR scans in 6 patients,and CT scans in 4 patients.Results ALL lesions detected were a solitary lesion.The distribution of BFH was in the tibia (n =5 ),femur ( n =3),fibula ( n =1 ),sacrum ( n =1 ),and thoracic vertebrae ( n =1 ).X-ray features included eccentric osteolytic lesions in 7 patients and centric in 2 patients,with clear boundary and thinning of the cortex,and 7 patients with varying degrees of ossified border were found. CT scan shows bone destruction with density similar to soft tissue.The majority of lesions ( n =3 ) were observed in the expanding shell of bone,2 patients in the tibia and 1 patient in the thoracic lesions with cortical bone perforation.The thoracic lesion as soft tissue mass was detected. All of the lesions detected in CT showed no periosteal reaction.In patients with MR images,hypo to isointense signal intensity on T1WI and hyperintense signal intensity on T2WI was found. All lesions on post-contrast T1WI were detected with homogeneous or heterogeneous lesion with moderate or significant enhancement.Conclusion Imaging features were typical for MFH which is useful tool helping correct diagnosis of MFH.

ACKGROUND:Autism is a kind of neurobiological disease.The increase of plasma concentration of 5 hydroxytryptamine(5 HT) is considered to be one of study results,which is the most definite and has the best repetition,for the biological investigation of autism. Whether the season of birth and maternal mood during pregnancy are correlated with the occurrence of autism? OBJECTIVE:To compare the differences of the plasma concentration of 5 HT,season of birth and the maternal mood during pregnancy between autistic and normal children,and probe into the cause of increased 5 HT in autism. DESIGN:An observational comparative study taking autistic and normal children as the subjects. SETTINGS:A clinical psychological department of a university hospital;Mental Health Institute of the Xiangya Second Hospital;A rehabilitation center for dumb children of city grade. PARTICIPANTS:Children in the autistic group(n=54),who were in accordance with the diagnostic criteria of autism in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM IV) and had the total score of social adaptive ability scale(SAAS) over 40, were selected from the Outpatient Clinic for Children of the Mental Health Institute,Xiangya Second Hospital of Central South University and the training class of autism of Shenzhen Special Education School;Children in the normal control group,who had no obvious somatic and neurological diseases,and developing delay detected by physical,neurological and mental status examinations, rough detection of developing level,were selected from the primary school and kindergarten in Changsha and Shenzhen cities. INTERVENTIONS:The plasma level of 5 HT was examined, season of birth and maternal mood during pregnancy were investigated in autistic and normal children.The children with autism were accessed with SAAS. MAIN OUTCOME MEASURES:The plasma level of 5 HT,the season of birth and the maternal mood during pregnancy in both groups. RESULTS:The score of SAAS in children with autism was 67.65± 1.67.The plasma level of 5 HT was(0.78± 0.32) μ mol/L in the autistic group,which was significantly higher than that in the normal control group [(0.62± 0.16) μ mol/L](t=3.17,P=0.002). There were 17 children with autism had increased 5 HT.Compare with normal children,most children with autism were born in winter and spring,and their mother had obvious mood problems during pregnancy. CONCLUSION:The 5 HT level is higher in children with autism than in normal children.Most children with autism were born in winter and spring,and their mother had obvious emotional problems during pregnancy.There are phase of high functioning of 5 HT in mother in key period of fetus cerebra development that may be one of the causes of hyperserotonemia in autism,and that is possibly one of the etiologies of autism.