Objective To explore the prognostic factors in patients with acute respiratory failure due to chronic obstructive pulmonary disease (COPD) in EICU. Method Clinical data of 39 patients admitted to EICU from May 2005 to May 2007 were retrospectivley analyzed. Results In death group, the pulmonary artery pressure (PAP) ,creatinine (Cr) ,APACHE-Ⅱ score, and APACHE-Ⅲ score were increased (P < 0. 05) and ICU stays were prolonged (P < 0.05) ; Respiratory rate (RR) and Glasgow coma score (GCS) were decreased (P < 0.05). Conclusion PAP, Cr, APACHE-Ⅱ score,APACHE-Ⅲ score,RR and GCS predict the prognosis of the patients with acute respiratory failure due to chronic obstructive pulmonary disease.

ObjectiveTo investigate the prevalence and the characteristics of heart failure (HF) in medical intensive care unit (ICU) so as to explore the factors contributing to HF.Methods A retrospective analysis of the data of HF was carried out in 887 HF patients (54. 2％ ) males; age (69.83± 13.57) years oldadmitted to the medical ICU from October 2006 through June 2010. Clinical variables were systematically reviewed for all enrolled patients. HF as either major or additional diagnosis was recorded and the potential risk factors for HF were explored. Left ventricular systolic function was evaluated in HF patients by using ejection fraction (EF) measured by echocardiography. Multivariate Logistic regression analysis was used to identify the independent factors contributing to HF in medical ICU patients. Results Of the 887 patients, 74. 1％ aged 65 years or over, and 53％ had organ dysfunction. The prevalence of HF in medical ICU patients was 22. 8％. Echocardiography measurement revealed that left ventricular systolic function was preserved in 62. 5％ of HF patients with an EF ＞ 50％. Underlying heart diseases were identified in 72. 8％ of the HF patients, and coronary artery disease accounted for the vast majority (52. 5％ ), followed by valvular heart disease ( 17. 8％ ). Structural heart diseases were not identified in 27. 2％ of the HF patients. 4) After the adjustment of age and gender, multivariate regression analysis showed that coronary artery disease ( OR =7. 364, 95％ CI: 4. 979 ～ 10. 890, P ＜0. 01 ), valvular heart disease ( OR =18. 023, 95％ CI: 9. 280 ～ 35. 002, P ＜ 0. 01 ), diabetes mellitus ( OR =2. 154, 95％ CI: 1. 227 ～ 3. 784, P =0. 0076), respiratory failure ( ( OR =1. 527, 95％ CI: 1. 045 ～ 2. 229, P =0. 0285 ), and renal dysfunction ( OR =2. 638, 95％ CI: 1. 621 ～ 4. 294, P =0. 0001 ) were associated with risk increased for HF in medical ICU. ConclusionsHF is highly prevalent in medical ICU and its etiology is multi-factorial. The high rate of HF with preserved EF highlights the importance of enhanced alertness for HF with preserved systolic function in ICU.

Objective To explore the characteristics and relationship among self-esteem, self-control and psychological symptoms of people with disablities, and to investigate the mediating effect of self-control. Methods 598 persons with disabilities, extracted by conve-nience sampling method from January to March, 2015, were assessed with Symptom Checklist 90 (SCL-90), Self-esteem Scale (SES) and the Self-control Scale (SCS) face to face. Results The detection rate of psychological problems of disabled persons was 58.03%. There was significant difference in the scores of SCL-90 among the subjects of different census registers (t=-4.664), disability types (F=5.774), in-come sources (F=5.402) and education levels (F=2.810) (P<0.05). There was significant difference in the score of SCS among different gen-ders (t=2.097), census registers (t=2.661), congenital disability or acquired disability (t=-2.617), disability types (F=5.338) and income sources (F=4.476) (P<0.05). There was significant difference in the score of SES among congenital disability or acquired disability (t=3.652), and different education levels (F=2.443) (P<0.05). The scores of SES (r=-0.179) and SCS (r=-0.396) negatively correlated with the score of SCL-90 (P<0.01), and the scores of SCS positively correlated with SES (r=0.216, P<0.01). SES had significant regression effect on SCL-90 and SCS. Both SES and SCS had significant regression effect on SCL-90 (P<0.01). Conclusion Self-control plays a part of the in-termediary role between self-esteem and psychological symptoms, self-esteem can not only directly affect psychological symptoms, but also affect psychological symptoms through self-control.

Objective To investigate the role of electromyography(EMG) in diagnosis of nervous system diseases in children.(Met)-hods EMG tests were carried out in 354 patients with nervous system diseases,and the data and results of EMG tests were analyzed.Results One hundred and sixty-six patients′ results of EMG were abnormal.Among these abnormalities,36 cases were myogenic,47 cases were neurogenic,abnormalities of 69 cases were located in peripheral nerves,3 cases got positive in repetitive nerve stimulation(RNS),and 11 cases were on the borderline.In 36 myogenic patients,clinical diagnosis were as follow: progressive muscular dystrophy(PMD,18 cases),polymyositis(2 cases),mitochondrial encephalomyopathy(1 case), and the other 15 cases had no definite diagnosis.In 47 neurogenic patients,the diagnosis were spinal muscular atrophy(SMA,29 cases),sequela of poliomyelitis(2 cases),acute transverse myelitis(ATM,4 cases),and the other 12 patients had no definite diagnosis.In 69 cases of peripheral nerve abnormality,diagnosis were injury of brachial nerve(23 cases),hereditary motor sensory neuropathy(HMSN,2 cases),Guillain-Barre syndrome(GBS,9(ca)-ses),chronic inflammatory demyelinating polyradiculoneuropathy(CIDP,1 case),injury of facial nerve(4 cases),injury of common(pe)-roneal nerve(6 cases),metachromatic leukodystrophy(MLD,1 case),and the other 23 patients had no definite diagnosis.Three patients who got RNS positive were all diagnosed myasthenia gravis(MG),and ocular type(1 case),general type(2 cases).Eleven patients whose EMG results were borderline were all diagnosed indefinitely.One hundred and eighty-eight patients had normal results of EMG test.The diagnosis of these patients were included ocular MG(21 cases),cerebral palsy(CP,5 cases),ATM(2 cases),polymyositis((1 case)),and some other nervous system diseases(21 cases),and the other 138 were diagnosed indefinitely.Conclusions 1.EMG plays an important role in definite diagnosis of PMD,SMA,poliomyelitis and nerve injury;2.EMG can provide clue or basis in the differential(dia)gnosis of nervous system diseases which involved lower motor unit;3.EMG test has very low positive results in children with MG;(4.EMG) has little help in diagnosis of diseases involved upper motor unit only.

Objective To study prospectively the safety and efficacy of the thromblytic therapy in acute submassive pulmonary thromboembolism (PTE) without randomized control.Methods A total of consecutive 177 patients with acute submassive PTE admitted to the emergency intensive care unit were screened from June of 2005 to May of 2012.After a comprehensive screening,102 patients were treated with thrombolytic therapy (TT group),and 75 with anticoagulation therapy (AT group).Clinical signs and physical examination findings were recorded 2 hours,24 hours and 7 days after treatment.Echocardiography (ECG) was repeated 24 hours later.Lung perfusion scan and CT pulmonary artery (CTPA) were repeated on the 7th day.All data was analyzed by paired t test and Chi-square test.Results ①Bleeding happened in 6 patients of TT group and in 1 patient of AT group (P ＞ 0.05),and no lethal hemorrhage occurred in the two groups.There were no statistically significant differences in demographics and clinical history of patients between TT group and AT group (P ＞ 0.05).②There were statistically significant changes in respiratory rate,heart rate and systolic blood pressure in the TT group 2 hours after treatment and great changes in systolic pressure of pulmonary artery (SPAP) and tricuspid regurgitation at 24 hours after treatment (P ＜0.01),whereas obvious change in respiratory rate in AT group was found 24 hours after treatment.③In the TT group 7 days after treatment,significant efficiency rate and total improvement of the deep vein thrombosis (DVT) identified by ultrasonography were 83.0％ and 96.2％ respectively,and those of CTPA and lung perfusion scan were 66.7％ and 98％ respectively.The efficiency of TT was significantly superior over AT in this respect (P ＜ 0.01).④The efficiency of TT given within 3 days after onset of PTE was significantly higher than that of TT conferred over 3 days after onset of PTE (P ＜ 0.01).Conclusions ①Thrombolytic therapy is safe and effective for the submassive PTE,but atypical cerebrovascular accident must be rule out first.②Thrombolytic therapy can improve the symptom of the patient in 2 hours compare with AT.③ Thrombus burden can be reduced more obviously in TT group after 7 days treatment compare with the AT group.④The effect of thrombolytic therapy depends on the time as ti given during the course of disease,the earlier administration the better efficacy.

Objective To investigate effects of Taikong Yangxin Prescription on left ventricular pump and contract function in rat after tail suspension.Methods Twenty four male Sprague-Dawley(SD)rats were randomly and divided into three groups:(A)normal control group,(B)tail-suspension group and(C)Chinese herb compound group(taking Taikong Yangxin Prescription and tail suspension).The left ventricular functions in rats were examined by echocardiography separately after 7 d and 28 d tail-suspension.Results After 28 d of tail-suspension,as compared with the tail-suspension group,LVDD in Chinese herb compound group increased significantly(P

Objective To investigate the clinical characteristics of pulmonary artery sarcoma (PAS) and pulmonary thromboembolism(PTE), to improve doctors' awareness and the early diagnosis of PAS.Methods The clinical data of 10 PAS cases confirmed with biopsy were retrospectively analyzed,and 10 cases with PTE were selected as control group.Results (1) Main clinical manifestations of the two groups were chest tightness, shortness of breath, intermittent syncope, palpitations, chest pain and cough, and there were no statistical significance differences between the two groups (P＞0.05).(2)There were 2 cases (20.0％) PaO2 ＜80 mmHg in patients with PAS.However, there were 8 cases (80.0％)PaO2 ＜ 80 mmHg in control group.The two groups had statistically significant difference (x2 =7.200, P =0.023).(3) Wells score : the cases with PAS was in low risk (80.0％ and 10.0％),however, the cases of control group was in medium and high risk(90.0％ and 20.0％).The two groups had statistically significant difference (P =0.005, 0.001).(4) The two groups had no statistically significant difference in ECG, UCG, X-ray, lung ventilation/perfusion (P＞ 0.05).(5) There had statistically significant difference in terms of LDH and CRP between PAS and PET group (100％ vs.0, x-2 =10.796,P=0.003;100％ vs.0, x2 =15.000, P =0.000).There was faster ESR in PAS group than control group,and the two groups had statistically significant difference (75％ vs.0, x2=1.400, P =0.011).There was no case of D-Dimer＞500 μg,/L in PAS group, while 10 cases in control group, and the two groups had significant statistical difference (x2 =17.000, P =0.000).(6) There was 1 case (12.5％) with DVT in PAS group, 6 cases (60.0％) in PTE group, and the two groups had significant statistical difference (x2=10.568, P =0.001).(7) The CTPA in PAS group showed filling defect in the main pulmonary artery trunk (85.7％ vs.0) ,left pulmonary artery (85.7％ vs.10.0％) ,right pulmonary artery(100％ vs.10.0％) and both left and right pulmonary artery (85.7％ vs.10.0％), the two groups had significant statistical difference (x2 =13.247, P =0.001;x2 =9.746, P=0.004;x2 =13.388, P =0.000;x2 =9.746, P =0.004).Conclusion PAS and PTE can' t be distinguished from the clinical symptoms, ECG, UCG, X-ray,lung ventilation/perfusion imaging.PAS is easily misdiagnosed as PTE.More attention should be given.PAS can be identified early through the blood gas analysis, hypoxemia,Wells score, LDH, CRP, ESR, D-Dimer, DVT and CTPA.

Objective To investigate whether simple visual assessment of FVERVOT(the right ventricular outflow tract Doppler flow velocity envelop) graphs aids in hemodynamic differentiation. Method The hemodynamics, echocardiography, and clinical data of 88 patients with pulmonary hypertension (PH) were reviewed. The FVERVOTgraphs were categorized into normal pattern (no notch; NN), late systolic notch pattern (LSN) or mid-systolic notch pattern (MSN). Results The pulmonary vascular resistance (PVR) was highest in the MSN pattern (9.2±3.5 WU; P＜0. 001), in comparison with LSN (5,7 ±3. 1 WU) and NN (3.3±2.4 WU) patterns. The ratio of stroke volume to pulse pressure (compliance) also varied with different patterns of FVERVOr graph (MSN = 1.2 ± 0. 5; LSN = 1.7 ± 0.8; NN = 2.6 ± 1. 7, P = 0.001 and 0.04 respectively compared with NN). The specificity and sensitivity of MSN were 96% and 71%, respectively in case of a PVR ＞ 5 WU (PPV 98%). In the patients with PH, any notching pattern of FVERVOT graph was highly associated with PVR ＞ 3 WU (OR = 22.3, 95 % CI: 5.2 ～ 96.4), whereas the NN pattern predicted a PVR ≤3 WU and pulmonary artery wedge pressure (PAWP) ＞ 15 mmHg (OR =30.2, 95%CI: 6.3 ～ 144.9). Conclusions Visual inspection of the shape of the FVERVOT graphs provides insight into the hemodynamic status of patients with PH.

OBJECTIVETo investigate the relationship of telomerase genes and the malignant transformation of atypical mammary ductal hyperplasia.

METHODSTelomerase genes hTR and hTRT in 50 cases of mammary hyperplasia (the cases included 6 benign hyperplasia, 9 mild atypical hyperplasia, 12 medium atypical hyperplasia, 23 severe atypical hyperplasia) and 26 cases of breast carcinoma were detected by in situ hybridization.

RESULTSThe expression of hTR and hTRT mRNA were weak or negative in benign hyperplasia (1/6, 0), weaker in mild-moderate atypical hyperplasia (2/9, 1/9, 4/12, and 3/12), strong in severe atypical hyperplasia (14/23, 60.9% and 12/23, 52.1%), while very strong expression (23/26, 88.5% and 21/25, 80.8%) in carcinoma of the breast. The difference between mild-moderate atypical hyperplasia, invasive ductal carcinoma and severe atypical hyperplasia was significant (P < 0.05) and the difference between severe atypital hyperplasia and intraductal carcinoma was not significant (P > 0.05).

CONCLUSIONSTelmerase genes (hTR, hTRT) expression is closely related to the malignant transformation of atypical hyperplasia. The reactivated telomerase may play a crucial role in the development of breast cancer.

Breast Neoplasms ; enzymology ; pathology ; Carcinoma, Intraductal, Noninfiltrating ; enzymology ; pathology ; DNA-Binding Proteins ; Female ; Gene Expression ; Humans ; RNA, Messenger ; Telomerase ; genetics

OBJECTIVETo investigate telomerase gene expression in precancerous mammary lesion, such as atypical ductal hyperplasia and breast cancer and to study the relationship between expression and malignant transformation.

METHODSExpression of human telomerase genes (hTR) and human reverse transcriptase gene (hTRT) in 76 cases of mammary tissue was evaluated using in situ hybridization and included 50 cases of mammary hyperplasia, 6 of which were benign hyperplasia, 9 were mild atypical hyperplasia, 12 were moderate atypical hyperplasia, 23 were severe atypical hyperplasia and 26 were mammary cancer.

RESULTSThe expressions of hTR and hTRT mRNA were much weaker or negative in benign hyperplasia (16.6%, 0), weak to mild moderate in atypical hyperplasia (22.2%, 11.1%, 33.3%, 25.0%), strong in severe atypical hyperplasia (60.9%, 52.1%), and significantly strong in mammary cancer (88.5%, 80.8%). The difference between mild-moderate atypical hyperplasia, invasive ductal carcinoma and severe atypical hyperplasia was significant (P < 0.05) and the difference between severe atypical hyperplasia and intraductal carcinoma was not significant (P > 0.05).

CONCLUSIONTelomerase genes (hTR and hTRT) expressions are related to the transformation of atypical hyperplasia. Activated telomerase may play a role in mammary cancer development.

Breast ; metabolism ; pathology ; Breast Neoplasms ; genetics ; pathology ; DNA-Binding Proteins ; Female ; Gene Expression ; Humans ; Precancerous Conditions ; genetics ; pathology ; RNA ; genetics ; physiology ; RNA, Messenger ; analysis ; Telomerase ; genetics ; physiology