28 patients with acute respiratory distress syndrome caused by 2009 H1N1 influenza were mechanically ventilated for 1 hour in the supine, lateral, semi-supine, lateral prone, and prone position respectively. Changes of heart rate, respiratory parameters and arterial partial pressure of oxygen ( PaO2 )were measured. There were no significant differences ( P ＞ 0. 05 ) of heart rate and mean arterial pressure among these postures. Lateral prone ( P ＜ 0. 05 ) and prone posture ( P ＜ 0. 01 ) , however, can both significantly improve tidal volume, mean airway pressure, PaO2, static lung compliance and oxygenation index. We concluded that mechanical ventilation delivered in the prone position can remarkably improve oxygenation in patients with H1N1 influenza-associated acute lung injury.

Objective To analysis the progress in prevention and control of iodine deficiency disorders (IDD) in Dalian and to provide a scientific basis for further prevention and control of the disease.Methods From 2006 to 2010,5 or 9 townships were randomly sampled from each county in Dalian,4 villages were sampled from each selected townships and 15 or 8 households were sampled from each selected villages for collecting salt samples and salt iodine level was determined by direct titration method.Sixty daytime urine samples from pregnant women,breast feeding women,infants and young children were collected,respectively,every year to detect urinary iodine level.From 2007 to 2009,2 to 11 counties were sampled and from each selected county one school was sampled to collect 100 daytime urine samples of children aged 8-10 and iodine content was determined.From 2006 to 2009,2 to 5 counties were sampled,from each selected county 2 to 5 schools were sampled and 100 children aged 8 to 10 in each selected school were sampled to detect intelligence quotient level and the thyroid volume.Results From 2006 to 2010,16 012 copies of households' edible salt samples were monitored; the average iodine content was ranged 29.68-31.51 mg/kg,the rate of qualified iodized salt in household ranged from 97.24％ to 98.42％.A total of 1398 copies of urine samples of pregnant women,486 breast feeding women,473 infants and 502 young children were monitored,and the median value of urinary iodine was 129.3-189.6,114.6-190.6,148.5-298.5 and 144.4-187.3 μg/L,respectively.A total of 1657 urine samples were monitored,1264 intelligence quotient level and 1197 thyroid volume of school-age children were determined,the median urinary iodine,thyroid goiter rate and intelligence quotient level was 217.9-266.7 μg/L,0-3.29％ and 110.4-117.2 μg/L,respectively.Conclusions From 2006 to 2010,the city's households qualified iodized salt coverage rate has reached the national standard for elimination of iodine deficiency disorders.The iodine nutrition of key population and school-age children has reached adequate level,the thyroid goiter rate is less than 5％,and the level of intelligence quotient has increased every year.But the iodine nutrition of breast feeding women in 2009 and 2010,pregnant women in 2010 is inadequate,so iodine nutrition surveillance and health education in pregnant and breast feeding women need to be strengthened in the future.

Objective To investigate the blood glucose changes in critically ill patients taken continuous renal replacement therapy(CRRT)before treatment and at different time points after treatment. Methods Sixtyseven critically ill patients were enrolled in the study,of whom 13 cases were treated conventionally and assigned as pre-treatment control group,while the other 54 cases undertook CRRT were assigned as CRRT group. The CRRT group were further sub-divided into four groups according to CRRT time((CRRT time ＜6 h group(n = 18),CRRT time of 6 - 12 h group(n = 18),CRRT time ＞ 12 h group(n = 18);or sub-divided into two groups according to circulating blood temperature(≤ 36. 5 ℃ group(n =27)and ＞ 36. 5 ℃ group(n =27));or sub-divided into two groups by sugar substitute fluid replacement solution as the formula group(the standard level of sugar content was 6. 9 mmol/L(n = 27)and sugar-free replacement fluid group(n = 27);or sub-divided into two groups according to the Glasgow Coma score(GCS)(GCS ≤ 8 points group(n = 24)and GCS ＞ 8 group(n = 30). Blood glucose level at different time points were measured. Results The longer CRRT cycle time,lower temperature,sugar substitute fluid replacement fluid worse GCS score corresponded to more dramatic blood glucose fluctuation at different time points in CRRT group,and it took longer time for them to recover to normal blood sugar level Conclusions During the CRRT process insulin secretion was suppressed and led to increase of blood sugar. In most cases the blood glucose returns to normal after CRRT treatment over time,but a small number of cases require clinical intervention.

Objective To evaluate the influence of age factors on etomidate sedative potency.Methods One hundred and fifty (ASA physical status Ⅰ or Ⅱ) patients of both sexes,scheduled for elective operation under general anesthesia,were divided into 3 groups according to age (n =50 each):group Y 18-44 yr,group M 40-64 yr and group O 65-75 yr.Each group was randomly divided into 5 subgroups receiving in'venous etomidate 0.07,0.09,0.11,0.13 and 0.17 mg/kg,respectively.Loss of consciousness was evaluated depending on loss of eyelash reflex within 5 min after intravenous administration.Results ED50 of etomidate inducing loss of consciousness was 0.13,0.11 and 0.09 mg/kg in group Y,M and O,respectively.Compared with that in group Y,ED50 was significantly decreased in group O,however,and showed no significant change in group M.Conclusion Age factors can affect sedative potency of etomidate,which appears greater in the elderly patients.

Objective:To explore the protective effect of sodium channels antagonists HOE642 on lung ischemia reperfusion and the role of the p38 mitogen activated protein kinase (p38MAPK) signaling pathway in this process.Methods:A total of 36 mice were randomly divided into a sham operation group (SHAM group),a lung ischemia reperfusion group (I/R group) and a lung ischemia reperfusion+HOE642 group (HOE group).The water content was detected by electronic scales,and the lung tissue pathological changes were observed under optical microscope.The inflammatory cytokines including IL-6 and TNF-α were examined by ELISA.The intracellular calcium fluorescence intensity was examined and observed under fluorescence microscope,and the protein expression of p38MAPK was detected by Western blot.Results:Lung water content in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).Lung interstitial edema,hemorrhage,lung tissue inflammatory cells infiltration were significantly alleviated in the HOE group than those in the I/R group,while the injury in the HOE group was aggravated than those in the SHAM group (both P＜0.05).T he IL-6 and TNF-α in lung tissues in the HOE group were lower than those in the I/R group,but higher than those in the SHAM group (both P＜0.05).Intracellular calcium fluorescence intensity in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).The protein expression of p38MAPK in lung tissues in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).Conclusion:HOE642 may exert protective effect on pulmonary I/R injury through regulation of the p38MAPK signaling pathway,resulting in reduction of intracellular calcium ion concentration and calcium overload,and decrease of inflammatory response.

To explore the relationship between maternal insulin levels and fetal insulin resistance.Maternal blood and venous cord blood samples were collected in gestational diabetes mellitus (GDM) mothers and control subjects.The glucose and insulin levels were measured and insulin resistance levels estimated.Maternal levels of insulin and homeostasis model of assessment for insulin resistance index (HOMAIR) were significantly higher in the GDM group than those in the control group (P ＜ 0.05) ; fetal levels of insulin and HOMA-IR were significantly higher in the GDM group than in the control group (P ＜ 0.05).Maternal insulin level positively correlated with fetal insulin (r =0.326,P ＜ 0.05) and HOMA-IR levels (r =0.378,P ＜0.05).In this study,a higher level of fetal insulin resistance was reported in the GDM group.And maternal hyperinsulinemia might affect fetal insulin resistance in pregnant women with GDM.

ObjectiveTo investigate the relationship between ceruloplasmin expression and Down syndrome (DS). MethodsDifferential protein expression in serum of six mothers with DS fetuses and six mothers with healthy fetuses was detected by two-dimensional electrophoresis and matrix assisted laser desorption ionization-mass spectrum,the results were confirmed by Western blot.The levels of serum ceruloplasmin in 11 mothers with DS fetuses,10 mothers with healthy fetuses,11 DS newborns and 10 healthy babies were detected by enzyme-linked immunosorbent assay.The difference between the two groups was compared by two-independent samples t test. ResultsTwenty-nine differential proteins were found in the serum of the mothers with DS fetuses; among which ceruloplasmin increased significantly compared with that in mothers with healthy fetuese with density ratio of 5.43 (t=2.7102,P＜0.05).Western blot results showed that the expression of ceruloplasmin in maternal serum with DS fetuses (0.95 ± 0.24) was higher than that of normal mothers (0.37±0.14) (t=2.9521,P＜0.05) ; while the expression of ceruloplasmin in DS babies' serum (0.74±0.03) was lower than that of normal newborns (0.89±0.06)(t=-2.9515,P＜0.05).The expression of ceruloplasmin in serum of mothers with DS fetuses [(346.5± 111.8) ng/ml] was higher than that of normal mothers [(248.6478.3) ng/ml] (t=2.301,P＜0.05) ; while the expression of ceruloplasmin in DS babies' serum [(166.1 ±55.0) ng/ml] was lower than that of normal newborns [(244.0±36.0) ng/ml] (t=-3.873,P＜0.01). ConclusionsAbnormal maternal and neonatal serum ceruloplasmin level might relate to DS.

Objective To investigate the relationship of TCM constitution and syndrome elements based on patients with hyperhomocysteinemia. Methods A survey was conducted among 1316 patients with diabetes, coronary disease, hypertension and cerebral infarction. Totally 326 patients with hyperhomocysteinemia were incorporated in diagnostic data and their constitutions were determined. At the same time, syndrome elements identification method for syndrome elements was applied for judgment, and consistency of the constitution and syndrome elements was analyzed. Results The survey showed that prevalence rate of population with hyperhomocysteinemia was 24.77%;there were 6 cases with mild nature, and 320 cases with biased constitution;phlegm dampness, blood stasis, qi deficiency of constitutions 110 cases, 73 cases and 59 cases, respectively;blood stasis, phlegm, qi deficiency, and dampness were the main syndrome elements of hyperhomocysteinemia, of 100 cases, 98 cases, 73 cases and 59 cases, respectively;the consistency of phlegm dampness constitution and syndromes of phlegm was the most obvious (Kappa=0.89, P<0.05). Conclusion Phlegm dampness, blood stasis, and qi deficiency were the most common constitutions of hyperhomocysteinemia;blood stasis, phlegm, qi deficiency and dampness were the main syndrome elements of hyperhomocysteinemia patients. The two results were consistent, and the consistency of phlegm syndrome and phlegm dampness constitution was the most obvious.

AIM: To discuss the effect of Smart Plug canalicular plug on aqueous-deficient dryeye.
METHODS:Forty-eight cases of aqueous-deficient dry eye patients in our hospital from May 2012 to April 2013 were selected for the study. After treated by Smart Plug canalicular plug, postoperative clinical efficacy, foundation Schirmer I test ( SIt) , tear film break-up time ( BUT ) , corneal fluorescein staining ( FL ) changes were observed.
RESULTS: Forty-eight patients were cured, 31 cases were markedly effective(65%), effective 14 cases (29%), invalid in 3 cases (6%), the total effective rate was 94%. Before treatment, SⅠt, BUT, and FL was ( 3. 49±1. 24 ) mm/5min, ( 3. 15±1. 07 ) s, and ( 2. 52±0. 11 ) points, respectively. After treatment, SIt, BUT, FL were significantly improved compared with before treatment, the difference was statistically significant (P<0. 05). One patient had postoperative foreign body sensation, 8h after shedding emboli; One patient granulation tissue after surgery 8mo, canalicular plug off. The remaining cases had no inferior lacrimal duct infection or granuloma.
CONCLUSION: Smart Plug canalicular plug is an effective treatment for aqueous-deficient dry eye, can effectively relieve symptoms, worthy of promotion.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Low Back Pain ; etiology ; Male ; Spinal Puncture ; adverse effects