Anemia, Aplastic ; therapy ; Child ; Female ; HLA Antigens ; genetics ; immunology ; Humans ; Mesenchymal Stem Cell Transplantation ; Peripheral Blood Stem Cell Transplantation

Objective To explore the effect of inhaled ambroxol hydrochloride(mucosolvan) and budesonide suspension(pulmicort respules) on the prevention and treatment of neonatal respiratory distress syndrome(NRDS).Methods Ninty-two preterm infants without asphyxia and mother suffered from illness,were selected from neonatal intensive care unit(NICU) in Jiangyin hospital from Oct.2003 to Mar.2006.Their gestational age ranged from 29 to 33 weeks and they were all cured within 2 hours after birth.They were divided randomly into treatment group(group A) and control group(group B) at equal number.All of them were given oxygen treatment,aminophylline,VitK1,nutrition support treatment and kept in infant incubator.Every 8 hours,inhaled ambroxol hydrochloride(10 mg/kg) and budesonide suspension(0.25 mg) driven by oxygen were given to group A.Meanwhile,only ambroxol hydrochloride(10 mg/kg) were given to group B.After 3 days,the data of p(O2) and p(CO2) of premature were detected at d1,2,3 in 2 groups.Result At d2,d3,the arterial blood P(O2) in group A were(8.01?0.62),(9.25?0.76)kPa respectively;At d2,d3,arterial blood P(O2) value in group B were respectively(7.63?0.59)kPa,(8.75?0.63)kPa.By that statistics handles two set of preemie d2,d3 arterial blood P(O2)value,difference had notable.Group A preemie d2,d3 arterial blood P(CO2) value were respectively:(4.55?0.58),(4.20?0.51)kPa;group B preemie d2,d3 arterial blood P(CO2) value were(4.87?0.67)kPa,(4.44?0.59)kPa respectively.By that statistics handles two set of preemie d2,d3 arterial blood P(CO2) value,difference had notable.Conclusion Inhaled ambroxol hydrochloride and budesonide suspension treatment has be well effect in NRDS.

OBJECTIVETo investigate the clinical application of free superficial iliac circumflex artery skin flaps, as well as the management of donor site defects.

METHODS17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face, neck, foot, hand, ankle and lower leg, respectively. The donor site defects were closed directly or covered by paraumbilical island flaps.

RESULTSThe 17 flap size ranged from 5 cm x 3 cm to 19 cm x 14 cm. 16 flaps survived completely except 1 flap with partial necrosis, which was closed by free skin graft. The donor site defects were closed directly in 10 cases, and covered by paraumbilical island flaps in 7 flaps without no flap necrosis. The abdomen had a good appearance.

CONCLUSIONSGood appearance can be achieved with free superficial iliac circumflex artery skin flaps for the defects on face, neck, foot, hand, ankle and lower leg. Paraumbilical island flap can be used for the donor site defects.

Arteries ; Foot ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Skin ; Skin Transplantation ; Transplant Donor Site ; surgery ; Wounds and Injuries ; surgery

BACKGROUND:The intracel ular accumulation of reactive oxygen species leads to oxidative stress. Hypoxia is widespread in physiological and pathological condition. Variation of bone proliferation and differentiation when bone tissues cultured or bone cel s induced toxicity by reactive oxygen species under hypoxia have not yet been reported. OBJECTIVE:To observe the biological characteristics of MC3T3-E1 pretreated with different concentrations of hydrogen peroxide (H2O2) in hypoxia, thus understanding the cel mechanism underlying prolonged bone healing in the elderly with osteoporosis and diabetes. METHODS:The MC3T3-E1 cel s pretreated with different concentrations of H2O2 were cultured in different oxygen concentrations. The proliferation of MC3T3-E1 was detected by cel counting kit-8. The cel differentiation was detected through alkaline phosphatase staining and alizarin red staining. Total RNAs were extracted and used for analyzing the mRNA levels of col age type 1, alkaline phosphatase and Cbfa1. RESULTS AND CONCLUSION:When MC3T3-E1 pretreated with 200μmol/L H2O2 for 6 hours, the cel proliferation was increased with time, but lower than that in the control group. The alkaline phosphatase activity was weakened, and the number of mineralized nodes was decreased at the early stage of differentiation. When MC3T3-E1 pretreated with 400μmol/L H2O2 for 6 hours, the cel proliferation was decreased obviously. The alkaline phosphatase activity was stil weakened, and the number of mineralized nodes was decreased further, but not affected by hypoxia. When MC3T3-E1 pretreated with 400μmol/L H2O2 for 6 hours and then cultured in hypoxia, the mRNA expression of Cbfa1 was decreased, but the mRNA expressions of col age type 1 and alkaline phosphatase were significantly increased. These results suggest that MC3T3-E1 pretreated with low concentration of H2O2 show a significant decrease in proliferation, while MC3T3-E1 pretreated with a high concentration of H2O2 and cultured in hypoxia show a decrease in osteogenic differentiation, especial y at the early stage of alkaline phosphatase formation.

A comprehensive physician authorization management system has been established at Renmin Hospital of Wuhan University in its effort of promoting the clinical standardization.This system covers authorization of prescription,disposition,surgery,and medical report among others,adhering to the principle of clear,complete quantitative competence-based,authorization.The training and assessment of physicians in parallel canimprove physicians' competence and quality of care.

Objective To observe the therapeutic effect of traditional Chinese medicine(TCM)granules made by the formula of Shegan Mahuang decoction for treatment of patients with asthma. Methods A prospective study was conducted,51 cases of light to moderate asthma(cold type)patients were randomly divided into treatment group (25 cases)and control group(26 cases). Conventional symptomatic treatments were of the same in two groups. The patients in control group were given salbutamol aerosol inhalation,100μg each time,4 times per day;based on the treatment of the control group,additionally the above mentioned TCM granules dissolved in water was administered orally 1 dose/day taken twice once in the morning and another once in the evening in treatment group. The therapeutic course was 12 weeks in both groups. Before and after treatment,the asthma control test(ACT)score,forced expiratory volume in 1 second(FEV1)and peak expiratory flow(PEF)were observed. The therapeutic effect,adverse reaction and compliance were evaluated. Results The number of patients with asthma completely controlled in the treatment group was significantly higher than that in the control group(16 cases vs. 9 cases,χ2=4.82,P=0.028). In the patients of two groups,FEV1,PEF and ACT scores were significantly improved after treatment,and in the treatment group,they were obviously higher than those in control group〔FEV1(L):2.67±0.46 vs. 2.32±0.47,PEF(L/min):327.6±49.4 vs. 273.1±42.8,ACT score:22.8±2.0 vs. 21.1±2.6,all P<0.05〕. After treatment,FEV1%predicted value was increased in the treatment group but decreased in control group,there was significantly statistical difference〔(0.68±0.07)% vs.(0.80±0.11)%,P<0.05〕,no significant adverse reaction was found,compliance was good. Conclusion TCM granules made by formula of Shegan Mahuang decoction can improve the clinical symptoms, pulmonary function and control level in patients with asthma,so it is an effective medicine for the control of asthma.

Brain Stem/pathology* ; Death, Sudden/etiology* ; Fatal Outcome ; Humans ; Intracranial Hemorrhages/mortality* ; Leukemia/pathology*

Objective To investigate the short- and long-term complications after endoscopic Oddi's sphincterotomy (EST) upon endoscopic retrograde cholangiopancreatography (ERCP) procedure and determine whether the size of EST correlates to the occurrence of EST complications.Methods 95 cases receiving EST in the process of ERCP in our hospital were studied and followed up. The patients were divided into large, moderate and small incision groups according to the size of EST and the states of short-term and long-term EST complications were statistically analyzed.Results The incidence of short-term complications of EST was 18. 94% (18/95). They included bleeding in the process of ERCP in 11 cases, delayed bleeding in 3, acute pancreatitis in 1, acute cholangitis in 2 and duodenal perforation in 1. All these patients but 1 with duodenal perforation were discharged after undergoing symptomatic treatments. Eleven out of the 95 patients had long-term complications (11.57 % ). These included biliary system infection in 5 cases, recurrent calculus of bile duct in 3, papilla stricture in 1 and chronic relapsing pancreatitis in 2. All 11 patients recovered after therapeutic ERCP again or symptomatic drug treatments. There was no significant difference in incidence of short-term (χ2 =2.433, P=0.296) or long-term complications (χ2 = 1.151, P=0.562) among the 3 groups. Furthermore, there was no statistical correlation between the incision size of Oddi and complications including operative bleeding (P=0.109), short-term complications (P=0.124) and longterm complications(P=0.402). Conclusion There are many short-term and long-term complications after EST, but there is no correlation between the complications and the incision size of Oddi. The occurring rate of complications might be reduced through accurate direction of papilla incision, avoidance from injury of blood vessel, keeping bile drainage unobstructed and protection of the function of Oddi sphincter as far as possible in the process of ERCP.

Objective To evaluate the two-stage repair in hypospadias cripples.Methods 35 patients with hypospadias cripples underwent two-stage repair.At the first stage,a full-thickness graft of skin or buccal mucosa was used for urethral plate reconstruction after the release of chordee.The second stage was performed 6 months after completion of the first stage.Tubularization of the replaced urethral plate was the preferred technique.Results There was no urethra stricture or “preplaced urethral plate ” atrophy.Fistula developed in 2 of 35 cases.Conclusion The twostaged technique was a useful strategy to deal with the myriad abnormalities encountered in crippled hypospadias.This technique could not only create a neourethra successfully,but also give the penis a near-normal shape and appearance.

OBJECTIVETo analyze the status and trend of injury deaths in Chinese people, and provide basic evidence for injury interventions.

METHODSData came from 2004-2005 the 3rd national retrospective sampling survey of death cause and covered 31 province-level regions and 160 surveillance spots in the interior of China, Total 142 660 482 person years were investigated. To describe the status of injury deaths, the crude death rate, years of potential life lost (YPLL), working years of potential life lost (WYPLL) and the standardized death rate were calculated. The population used for standardization was from census in 2000 and each five-year was counted as an age group; To analyze the trend of injury deaths, the constitution of the death causes were calculated based on the data of 1991-2000 national disease surveillance system which covered more than 10 000 000 population and 145 surveillance spots.

RESULTSThe total number of residents in survey districts died of injury between 2004 and 2005 was 87 753 (male 59 664, female 28 089, urban 23 308, rural 64 445); the crude death rate of injury in China 2004-2005 was 61.51/100 000 and accounting for 10.10% of all deaths; the standardized death rate was 58.45/100 000, ranking the fourth among the main cause of death for Chinese people. The YPLL of injury was 1579.61 person years per 100 000 and the WYPLL was 1721.41 person years per 100 000. The crude death rate of injury was 81.76/100 000 in male and 40.31/100 000 in female; the standardized death rates were 79.96/100 000 and 36.25/100 000, respectively. Injury mortality in male was two times higher than that in female. The crude death rates of injury were 48.66/100 000 in urban area and 68.01/100 000 in rural area; the standardized death rate were 44.08/100 000 and 66.25/100 000, respectively; the mortality in rural area was 1.4 times higher than that in urban area. The mortality for the aged 15 - 44 was 48.94/100 000(35 497/72 531 671) and accounting for 40% of all deaths, injury was the first cause of death for the aged 15 - 44. During 2004-2005, the top five causes of death related to injury were traffic accidents, suicide, falls, drowning and poisoning; the cases were 29 669, 18 678, 10 901, 7752, 4857 respectively in survey districts; the crude death rate were 20.80/100 000, 13.09/100 000, 7.64/100 000, 5.43/100 000, 3.40/100 000 respectively. From 1991 to 2005, the proportion of all injury deaths due to traffic accident increased from 15.00% (1551/10 338) to 33.79% (14 792/43 774) which showed a rising trend, the proportion of all injury deaths due to suicide decreased from 26.66% (2756/10 338) to 20.46% (8599/43 774) and the proportion of all injury deaths due to fall increased from 5.15% (532/10 338) to 12.87% (5630/43 774).

CONCLUSIONInjury is the primary cause of death resulting in premature death among Chinese people, traffic accident is the first cause of injury death. Since 1990s, the pattern of injury mortality of Chinese people has changed.

Accidents ; mortality ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Cause of Death ; trends ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Young Adult