Objective To summarize and analyze the experiences on clinical application of extracorporeal membrane oxygenation (ECMO), and on the prevention of complications. Methods Seven patients, suffered from heart and respiratory failure after heart surgeries with no obvious curative effect by conventional therapy, were treated with ECMO adjunctively. Centrifugal pump assistant device was adopted for five cases, while the other two cases were treated with pulsated pump assistant device, and vasoactive agents were used in all the seven cases. Results After using of ECMO, two cases died of pulmonary infection, one died of thrombosis, one died of disseminated intravascular coagulation (DIC) induced by hemolysis, and the other three cases were successfully recovered and discharged after treatment. Other complications included hemorrhage, right heart failure, arrhythmia and hypotension, etc., and were recovered after treatment. Conclusions Clinical symptoms must be monitored after cardiac surgical operations, and ECMO should be used adjunctively once heart and/or respiratory failure appear. During the ECMO treatment, it is also import to prevent from the complications, once they occur, active therapies must be carried out to save the patients' lives.

Objective To investigate the correlation among HBV infection models,HBV Pre-S1 antigen and HBV DNA loads in serum and to provide evidence for the diagnosis and treatment of hepatitis B.Methods Hepatitis B markers,HBV Pre-S1 antigen and HBV DNA loads in serum samples were detected simultaneously for 1037 cases.Results The positive rate of HBV Pre-S1 antigen was higher in HBsAg,HBeAg and HBcAb positive model than that in other models(P0.05).Conclusion The quantitative detection of HBV DNA is important for the prevention of HBV infection.The combination assay of serum HBV markers,Pre-S1 antigen and HBV DNA load was beneficial to the monitoring of disease condition of hepatitis B and to the improvement of therapeutic effect.

Objective To investigate the efficacy of Yiqing capsules and Cefaclortablets in the treatment of simplex anaphylactoid purpura. Methods In this randomized,simple-blind, controlled study, all of 191 simplex anaphylactoid purpura patients,the throat secretion Group A βhemolytic streptococci antigen test was positive ,92 patients of control group were treated Cefaclor tablets and regular treatment,99 patients of test group were Yiqing capsules and Cefaclor tablets. Results After 10 days treatment,the clinical efficacy of the test group and the control group were 91.9% ,75.0% ,the test group was obviously higher than that of the control group(P ＜ 0.01), and the negative rate of the throat secretion Group A βhemolytic Streptococci antigen test of the test group was higher than that of control group, (P ＜0.01). the commencements of response of the test group was earlier than that of the control group(P ＜0. 01) ,the frequencies of recurrence of the test group were lower than that of the control group (P ＜ 0. 05).Conclusion Yiqing capsules combined cefaclor in treatment of simplex allergic purpura could improve efficacy, and reduce the treatment time.

Epidemiological, clinical, laboratory and treatment data, as well as outcomes of 66patients diagnosed as brucellosis during 1984 to 2010 in Peking Union Medical College Hospital were retrospectively analyzed. Thirty-four (51.5%) patients had a history of close contact with sheep or cows infected with brucellosis, eight (12. 1% ) had eaten not-fully-boiled or roasted mutton, three (4. 5% ) had drunk or contacted with contaminated milk, and transmission route was unknown in 21 (31.8%). The most common manifestations were fever ( 97.0%, 64/66 ), loss of appetite and fatigue ( 93. 9%, 62/66 ),sweating (47.0%, 31/66), myalgia and arthralgia (54. 5%, 34/66 ), hepatomegaly (27.3%, 18/66),splenomegaly (37.9%, 25/66), increased erythrocyte sedimentation rate (ESR) (62. 1%, 41/66), and elevated C-reactive protein (65.4%, 34/52). Average interval from onset to diagnosis was 19. 2 weeks. All 66 patients were positive in serum agglutination test for BruceUa, and 28 (42. 4% ) positive in blood or bone marrow culture for Brucella. Sixty-five of 66 patients were treated by standard combined treatment with rifampicin, quinolone, minocycline and streptomycin, with all effective, and only four with mild liver damage in treatment who got better after discontinuing medicines and changing treatment regimen.

Chitosan(CS)surface was modified with hydrophobic octyl groups to prepare N-octyl chitosan(nitro-gen-octyl chitosan;OC).Then hydrophilic group carboxyl-polyethylene glycol-amino (PEG);tumor-targeting lig-and D-glucosamine(DG);and membrane-penetrating peptide 9-D-arginine(9R)were linked to OC successively. Then the DG and 9R modified chitosan micelle (DG/9R-PEG-OC)with tumor-targeting and transmembrane effect was prepared.By hydrogen nuclear magnetic resonance spectrometer (1 H NMR)and sodium dodecyl sul-fate polyacryl amide gel electrophoresis(SDS-PAGE);the successful formation of DG/9R-PEG-OC was certified;with particle size of 151.8 nm and Zeta potential of 16.5 mV.The morphology of chitosan micelle observed by transmission electron microscope was homogeneous spherical structure.The drug loading content (DLC)(using fluorescein as a model drug)and encapsulation efficiency (EE)were about 28.2% and 75.0% measured by UV-visible spectrophotometer.Meanwhile;the drug showed a controlled releasing profile out of the micelle.Cellu-lar uptake experiments indicated DG/9 R-PEG-OC micelle had a significant tumor-tageting and transmembrane effects;especially on HepG2 cells;which exbihited high expression of the glucose transporter.Thus DG/9R-PEG-OC micelle could be a promising drug targeted delivery system of hydrophobic antitumor drugs.

BACKGROUND:Recently, periprosthetic femoral fractures have been a common complication after total hip replacement. Vancouver type B1 periprosthetic femoral fractures commonly received internal fixation due to stable femoral prosthesis and less bone defects.
OBJECTIVE:To evaluate the effect of the application of Synthes cable system in the treatment of Vancouver type B1 periprosthetic femoral fractures after total hip replacement.
METHODS:From May 2009 to October 2012, 18 patients with Vancouver type B1 periprosthetic femoral fractures were treated with Synthes cable system in the Department of Orthopedics, Nantong First People’s Hospital. There were 8 males and 10 females with an average age of (62.67±8.67) years ranging 45 to 80 years. They received a further consultation at 1, 3 and 6 months after treatment. The function of hip joint was evaluated by Harrris evaluation standard:ful marks, 100 points, ≥ 90 points, excellent;80-89 points, better;70-79 points, good;<70 points, poor.
RESULTS AND CONCLUSION:Al 18 patients were fol owed up for 6 to 43 months. Mean healing period was (19.06±4.04) weeks. Harris score was (22.3±3.6) points before treatment in 18 cases. Harris score was higher significantly at 1, 3 and 6 months after treatment compared with that before treatment (P<0.01), and the recovery of hip function was good. Results indicated that Synthes cable system could help to restore the normal anatomic structure of femur in the greatest extent, showing simple operation, little injury, high stability and high safety. It is an ideal method for treating Vancouver type B1 periprosthetic femoral fractures.

BACKGROUND: Many experiments have proved that heavy-load movement training causes the acute increase of free radicals. The increase of endogenous free radicals and caused cellular and subcellular lipid peroxidation strengthening injure the structure and function of tissue cells, thereby, decrease motor ability. Sleep deprivation also causes the increase of oxygen free radicals.OBJECTIVE: To observe the changes in malondialdehyde (MDA) and glutathione (GSH) levels as well as superoxide dismutase (SOD) activity in serum of acute exhaustive exercise rats following different time periods of sleep deprivation.DESIGN: A randomized controlled animal experiment.SETTING: Laboratory of Exercise Sciences & Sports Medicine, Physical College, Hunan Normal University.MATERIALS: Thirty healthy male SD rats of clean grade, weighing about (220±13)g, provided by Experimental Animal Center of Hunan Agricultural University, were involved in this study.METHODS: This experiment was carried out in the Laboratory of Exercise Sciences & Sports Medicine, Physical College,Hunan Normal University from April 2006 to May 2006. Thirty rats were randomized into 5 groups: blank control group,simple exercise group, sleep deprivation 24 hours group, sleep deprivation 48 hours group and sleep deprivation 72 hours group, with 6 rats in each group; Rats in the blank control group were allowed to sleep normally, but not do exercise; Rats in the simple exercise group were allowed to sleep normally and executed after acute exhaustive exercise; Rats in the sleep deprivation 24, 48 and 72 hours groups were deprived their sleep for 24, 48 and 72 hours,respectively, then they were executed after acute exhaustive exercise. Method of gentle handling was used in creating rat models of sleep deprivation; Rats in the simple exercise group and sleep deprivation groups were forced to do exercise according to the rat exercise model project established by Bedford: treadmill gradient 10°, speed 19.3 m/min, all the exercise rats were exhaustive (Exhaustion criteria: At the end of exercise, rats reached 1/3 of runway over 3 times;Various stimulations for expelling were invalid. After running, rats presented with breathlessness, expression lassitude,ventral decubitus, slow stimulus response, weaker escape response in being captured). After experiment, rats in each group were executed under the anesthetic state, and their blood was taken out, and centrifuged after natural clotting.Supernatant fluid was taken for detecting MDA and GSH levels as well as SOD activity.MAIN OUTCOME MEASURES: Changes in MDA and GSH levels, and SOD activity in rat serum.RESULTS: Thirty rats were involved in the final analysis. ① MDA level in the simple exercise group was higher than that in the blank control group (P＜ 0.01). MDA level in the sleep deprivation 24 hours, 48 hours and 72 hours was higher than that in the simple exercise group, respectively (P ＜ 0.01). MDA level in the sleep deprivation 72 hours was statistically higher than that in the other sleep deprivation groups, respectively (P ＜ 0.01). ②GSH level in the simple exercise group was lower than that in the blank control group (P ＜ 0.01). GSH level in the sleep deprivation 24 hours group was higher than that in the simple exercise group [(P ＜ 0.01). GSH level in the sleep deprivation 24 hours and 48 hours groups was lower than that in the simple exercise group, respectively (P ＜ 0.05, 0.01). There were statistical differences in GSH level among sleep deprivation groups (all P＜ 0.01). ③ SOD activity in the simple exercise group was lower than that in the blank control group (P ＜ 0.01); SOD activity in the sleep deprivation 24, 48 and 72 hours groups was lower than that in the simple exercise group, respectively (P ＜ 0.01); SOD activity in the sleep deprivation 48 and 72 hours groups was significantly lower than that in the blank control group, respectively (P ＜ 0.01); There were statistical differences in SOD activity among sleep deprivation groups (P ＜ 0.01).CONCLUSION: Sleep deprivation can cause serumal oxidative stress injury of rats; With elongation of time of sleep deprivation and exhaustive exercise, oxygen free radical production in serum of rats accumulates more and more, ability to get rid of oxygen free radical becomes weaker and weaker, and injury to body is more and more obvious.Serumal oxidative stress status of acute exhaustive exercise rats following sleep deprivation

Objective To investigate the clinical,neuroradiologic characteristics and possible causes in 3 patients with combined developmental venous anomalies (DVAs) and cerebral cavernous malformations (CCM).Methods The clinical examination,magnetic resonance imaging (MRI) T1-weighted (T1 WI),T2-weighted (T2WI),susceptibility-weighted imaging (SWI) or T2 fast field echo (T2 FFE),contrast-enhanced MRI at 1.5 T field strength and digital substrate angiography were performed in 3 patients.Results Three patients presented with the seizure,vertigo,and dizziness respectively.MRI findings of reticulated “popcorn like” lesion with complete hemosiden rim showed typical sign of CCM.DSA,contrast-enhanced MRI and MRI-SWI revealed the caput medusae of the medullary veins and collected veins which was drained into subcortical and deep venous system,which indicated DVAs in 3 patients.The angulated medullary veins and collected veins in approaching distal zone of CCM were observed.Conclusion DVAs can be combined with CCM.The angulated medullary veins and collected veins combined with CCM in same territory reveals that the angioarchitectural factors is a key factor in pathogenesis of cavernous malformation.

Objective T o explore the difference of eye m ovem ent characteristics betw een uncooperative and cooperative subjects w ith m ental disorder after cerebral traum a. Methods T hirty-nine subjects w hich needed psychiatric im pairm ent assessm ent w ere selected. A ccording to the binom ial forced-choice digit m em ory test (BFD M T),allsubjects w ere divided into cooperative and uncooperative groups. The subjects w ere asked to take the im age com pletion test from W echsler adult intelligence scale. M eanw hile, the data of eye m ovem ent track, fixation, saccade, pupil and blink w ere recorded by the track system of eye m ovem ent. Results T here w ere significantly differences (P<0.05) in the data of saccade betw een coopera-tive (10 cases) and uncooperative groups (29 cases). T he frequency, tim e, am plitude, acceleration of saccadic in uncooperative group w ere significantly higher than cooperation group. T he saccade latencies of cooperation group increased m ore than uncooperative group. T here w as a significant difference (P<0.05) in total discrete distance, average distance and total tim e of fixation betw een tw o groups, w hile the aver-age duration tim e, num ber and frequency of fixation had no significantly difference (P>0.05) betw een tw o groups. A nd the blink frequency of cooperation group w as higher than uncooperative group. Conclusion E ye m ovem ent can be an objective index for the prim ary judgm ent of cooperation level.

Using objective structuned clinical exammation ,OSCE to access a new resident standardized training , analyze the result and perform stratifying management and teaching based on the result , which may improve the effi-ciency and effectiveness of resident standardized training .