Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; diagnosis ; prevention & control ; therapy ; Intracranial Hemorrhages ; diagnosis ; prevention & control ; therapy ; Phenobarbital ; therapeutic use

Neuronal damage is associated with the excessive stimulation of N-Methyl-D- Aspartate (NMDA) receptors by glutamate during cerebral ischemia.Because of non-selective NMDA receptor antagonist can influence all NMDA receptors and produce adverse effects,and its clinical application has been restricted significantly,an increasing attention has been paid to the selective NMDA receptor in recent years.NR2B subunit antagonists are mainly divided into piperidine derivatives,amide derivatives,amidine derivatives,and aminoquinoline derivatives,etc. The representative drugs include ifenprodil and eliprodil.These drugs can selectively act on NMDA receptor NR2B subunit,and they are expected to become safe and effective neuropro- tective agents in clinical practice.

Adult ; Aged ; Humans ; Middle Aged ; Pneumoconiosis ; diagnostic imaging ; Radiography, Thoracic ; Retrospective Studies

Adult ; Drowning ; Humans ; Hydrogen Sulfide ; poisoning ; Male ; Radiography, Thoracic ; X-Ray Film ; Young Adult

OBJECTIVE To investigate the existence of genes for beta-lactam antibiotic resistance and for aminoglycosides modification enzymes(AMEs) in Pseudomonas aeruginosa(PAE) isolates from ICU patients and analyze the homology among strains.METHODS ?-Lactamase genes including TEM,SHV,OXA-10,PER,VEB,GES,CARB,IMP,VIM,SPM,GIM,DHA,FOX,MOX and oprD2,were detected by PCR amplication in 21 PAE isolates.The genes for AMES including aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅰ,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰwere determined by PCR amplification as well.RESULTS Among 21 isolates 21(100%),2(9.5%),1(4.8%),2(9.5%)and 4(19.0%) were positive for TEM,SHV,GES,CARB and VIM genes,respectively.The deletion of oprD2 gene was found in 14 out of 21 strains.Other ?-lactamase genes were absent in all isolates.As for AME genes,aac(3)-Ⅱ,aac(6″)-Ⅰ,aac(6)-Ⅱ,ant(3″)-Ⅰ,ant(2″)-Ⅰ and aac(3)-Ⅰgenes were present in 19.0%,23.8%,9.5%,4.8%,and 19.0% of 21 isolates,However,aac(3)-Ⅰ gene was no position in any isolates.CONCLUSIONS P.aeruginosa carries various beta-lactamase and AME genes in ICU patients.Genetic cluster analysis suggested that clonal propagation result in nosocomial infection of PAE.

Objective To explore the clinical modalities and diagnosis of respiratory failure due to laryngotracheal disorders in children,in order to reduce the misdiagnosis.Methods Fifteen patients(11 cases were male,4 cases were female) with respiratory failure in Intensive Care Unit, Tianjin Children′s Hospital from Jul.2006 to Jul.2009 were selected.Data including history,characteristics and results of spiral computerized tomography(CT) and reconstruction and magnetic resonance imaging(MRI) were reviewed.Results The major clinical manifestations indicated that 7 cases had laryngeal stridor,6 cases had recurrent pneumonia,5 cases had cyanosis after crying,and 12 patients were complicated with respiratory failure in 12 hours.Nine cases were recovered,3 cases were given up,and 3 cases died.All patients were performed with CT about laryngohypopharynx,and the results were cyst of root of tongue in 3 cases,trachea pressed by cyst of parapharyngeal space in 1 case.There were 11 cases examined by spiral CT and reconstruction,in which 6 cases were confirmed as tracheal stenosis,2 cases were left bifid tracheostoma,2 cases were pulmonary artery sling,and 1 case was diagnosed as tracheomalacia.Chest X-ray radiograph indicated that bronchopneumonia in 8 cases,bronchitis in 3 cases and negative in 4 cases.Echocardiograph examination was performed among 11 cases,in which 2 cases were pulmonary artery sling,2 cases were atrial septal defect,1 case was patent ductus arteriosus, and 6 cases were negative.Conclusions There is high morbidity of respiratory failure caused by laryngotracheal disorders in infants,but misdiagnosis ccures usually because of non-specific symptoms.If the infant must depend on mechanic ventilation for a long time and has airway obstruction,he should be examined early by using spiral CT.

Imaging diagnosis is one of the main bases for the diagnosis of occupational pneumoconiosis. At present the - diagnosis of occupational pneumoconiosis is mainly based on high kV X ray chest radiography or chest digital radiography. With （ ） ， （ ） the wide application of computed tomography CT in occupational lung diseases high resolution CT HRCT is increasingly Update： Standardized CT/HRCT Classification of Occupational valuable in the diagnosis of occupational pneumoconiosis. The and Environmental Thoracic Diseases in Germany， ， published in 2014 is the latest and highly reliable standard. The standard - - - recommends the use of low dose HRCT scanning regimens and whole lung thin layer volumetric scanning with a thickness of - ， ， 1.0 mm and high resolution reconstruction which classify CT image quality into four levels and describes methods for （ ， classification and quantitative recording of CT manifestations of lung lesions including round opacities irregular and/or linear ， ， ， ， ） opacities ground glass opacity honeycombing emphysema and large opacities and pleural lesions. It is beneficial for ， ， ， epidemiological research early screening diagnosis and differential diagnosis treatment and prognosis of occupational ， pneumoconiosis as well as the comparison of international data related to occupational pneumoconiosis.

Imaging diagnosis is one of the main bases for the diagnosis of occupational pneumoconiosis. At present the - diagnosis of occupational pneumoconiosis is mainly based on high kV X ray chest radiography or chest digital radiography. With （ ） ， （ ） the wide application of computed tomography CT in occupational lung diseases high resolution CT HRCT is increasingly Update： Standardized CT/HRCT Classification of Occupational valuable in the diagnosis of occupational pneumoconiosis. The and Environmental Thoracic Diseases in Germany， ， published in 2014 is the latest and highly reliable standard. The standard - - - recommends the use of low dose HRCT scanning regimens and whole lung thin layer volumetric scanning with a thickness of - ， ， 1.0 mm and high resolution reconstruction which classify CT image quality into four levels and describes methods for （ ， classification and quantitative recording of CT manifestations of lung lesions including round opacities irregular and/or linear ， ， ， ， ） opacities ground glass opacity honeycombing emphysema and large opacities and pleural lesions. It is beneficial for ， ， ， epidemiological research early screening diagnosis and differential diagnosis treatment and prognosis of occupational ， pneumoconiosis as well as the comparison of international data related to occupational pneumoconiosis.

Objective To perform a biomechanical study on and compare the stability of internal fixation with closed Kirschner wire in different spots from the epicondylus medialis to sulcus nervi ulnaris and epicondylus lateralis of humerus in the treatment of GartlandⅢsupracondylar fractures of humerus in children in order to provide basis for avoiding cubitus varus in clinic.Methods Twenty models of su- pracondylar fractures were made from ten humerus samples,then divided into two groups(group A and group B).They were fixed with closed Kirschner'wires.Ulnar Kirschner wire varied.In group A five spots were selected averagely from the epicondylus medialis to the sulcus nervi ulnaris.Kirschner wires entered from one of the five spots into another spot of humerus.In group B Kirschner wires entered defferent spots of humerus from the central spot of sulcus nervi ulnaris.Biomechanical tests were carried out,such as axial load,axial displacement,stress intensity,axial rigidity and anti-twisty ability.Forty-six children with Gart- landⅢsupracondylar fracture of humerus were treated and followed up for more than one year.Results In beth groups,with the angle of Kirschner wires and fracture side increasing,the strain and the vertical displacement decreased,the stress intensity and the axial rigidity increased,and the anti-twists ability was enhanced.There was statistic difference(P＜0.05).The follow-up of the 46 patients showed the elbow joint function recovered well with no cubitus varus malformation.Conclusion Internal fixation with closed Kirschner wires in sulcus nervi ulnaris from the epicondylus medialis and the epicondylns lateralis of humerus for GartlandⅢsupracondylar fracture of humerus in children has the advantages of enhancing bio- mechanical stability,effective prevention of secondary replacement of outlying black of the fracture and a- voidance of cubitus varus.It can be widely used clinically.

Objective To evaluate the overall effect of transsphenoidal microsuegery for 23 patients with non-adenomas disease intrasellar region.Methods A toal of 23 patients with non-adenomas disease in- trasellar region,7 cases of Rathke's cleft cyst,3 cases of craniopharyngiomas,2 cases of meningiomas,2 ca- ses of pituitary tuberculous granuloma,5 cases of pituitary abscess,2 cases of empty sella,2 cases of chord- mas,were treated via sublabio-septo-sphenoidal microsurgery.Results There were among the 23 patients, groos total removal of the disease were achieved in 14 cases,subtotal removal in 7 cases,and partial removal in remain 2 cases.Diminished visual activity and visual field defects were improved in 13 cases.Menstrual disorder in all female cases and sexual disturbance in male were improved.There was no death in group. Conclusion Microsurgical technique via transsphenoidal approach is a safe and effective one for the treatment of patients with non-adenomas disease intrasellar region.