Objective To discuss the efficacy and relative factors that affect the sequential therapy of invasive and non-invasive mechanical ventilation in treating severe respiratory failure.Methods We analyzed the clinical data of the patient who was hospitalized in Respiratory Department of the Sixth Hospital of Luohe on 3th February 2008.Results The patient received invasive mechanical ventilation for 4 days,then changed to mask non-invasive positive pressure ventilation for 10 days,while receiving comprehensive treatment of anti-infection and bronchial expansion,etc.Then the patient was recovered.Conclusion The sequential therapy of invasive and non-invasive mechanical ventilation in treating severe respiratory failure is effective.The efficacy depends on the optimum converting time between invasive and non-invasive mechanical ventilation,the choice of ventilator and the patient′s compliance.

Objective To investigate the effectiveness of percutaneous intracystic steroid injection using two needles in the treatment of solitary bone cysts in children. Methods A total of 28 children with solitary bone cyst underwent steroid injection from January 1996 to January 2004. Under fluoroscopy, two fine needles (either bone marrow biopsy needle or lumbar puncture needle) pierced the bone cyst by way of the top and the bottom of the cyst, respectively. The intracystic fluid was drawn off, the cyst cavity irrigated and the steroid injected into. Results Follow-up checkups for 10~62 months (mean, 28 months) in 27 children found no complications. According to the Chigira classification on the new bone formation, 20 cases were classified as grade Ⅳ, 5 case grade Ⅲ, 1 case grade Ⅱ and 1 case grade Ⅰ, the cure rate being 92 6% (25/27). The time for bone cysts to grow together again in the 25 children was 3~10 months (mean, 4 5 months). Conclusions Percutaneous intracystic steroid injection using two needles for solitary bone cysts in children is simple, safe and effective.

Objective To explore the changes and clinical significance of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen time(FGB)and platelet(PLT)on Kawasaki disease(KD)in children with acute and convalescent 10 d,which aimed at early diagnosis,prediction and prognosis of coronary artery lesions.Methods Thirty-eight cases who were diagnosed KD were selected as KD group,30 cases age-matched acute respiratory infections in children with fever as fever group,moreover,30 cases of a class of elective surgery preoperative children admitted to surgical departments were put as control group.The plasma PT,APTT,TT,FGB,PLT of all cases and plasma APTT,FGB,PLT in recovery 10 d in children with KD disease were detected,and then the results were compared between the 3 groups;and the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d to coronary artery dilatation groups or not were compared.Results 1.APTT prolonged and FGB,PLT increased in KD children with acute stage,which had a significant difference compared with other groups(Pa0.05).2.When comparing the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d,the difference was significant(Pa

Objective To study the immunophenotypic features of NK/T cell lymphoma in children and its association with Epstein-Barr virus (EBV) infection. Methods Five cases of children′s NK/T cell lymphoma were studied. CD45RO, CD3?, CD56, CD20, TIA-1 and granzyme B were detected by immunohistochemistry staining for investigating immunophenotype. The expression of EBV-latent membrane protein (LMP-1) were detected by immunohistochemistry. EBV-encoded RNA (EBER1/2) were detected by in situ hybridization (ISH). Results CD45RO, CD3?, TIA-1 and granzyme B were positive in 5 cases, CD56 was positive in 2 cases, while CD20 negative in 5 cases.EBER1/2 positive in 4 cases and LMP-1 positive in 3 cases.Conclusions NK/T cell lymphoma in children is strong associated with EBV infection,and EBV infection may play an important role in the pathogenesis of children NK/T cell lymphoma.

Objective Liver dysfunction is a common complication of hyperthyroidism [ mainly Graves’ disease(GD)], that may restrict the choice as well as affect the ultimate outcome of treatment. The purpose of this study was to describe the clinical and biochemical patterns in patients suffering from Graves’ disease and liver dysfunction and to determine influential factors. Methods A total of 1 928 patients received radioactive iodine, 131 I treatment. Before 131 I therapy, 24 h radioactive iodine uptake of thyroid(24 h RAIU), serum free triiodothyronine (FT3 ), free thyroxine( FT4 ), sensitive thyroid-stimulating hormone( sTSH), anti-thyrotrophin receptor antibody (TRAb), thyroglobulin antibody(TgAb), anti-thyroid peroxidase antibody(TPOAb), and serum hepatic function parameters etc were performed. Data were analyzed by the unpaired t-test, the independent samples t-test, the χ2 test, logistic regression, and Pearson bivariate correlation. Results Ages, the course of Graves’ disease, the weight of thyroid, FT4 , TPOAb, and TRAb in Graves’ disease patients complicated with liver dysfunction were higher than those in patients with normal hepatic function, as shown in table 1. The influential factors including age, course of Graves’ disease, heart rate, weight of thyroid, FT4, 24 h RAIU, TgAb, TPOAb, and TRAb. 24 h RAIU were the protecting factors. Age, course of Graves’ disease, heart rate, weight of thyroid, FT4 , TRAb, and TPOAb were the risk factors. Conclusion The risk of liver dysfunction in patients with Graves’ disease was increased in the following cases: age over 45 years, heart rate above 90 bpm, weight of thyroid more than 35 g, course of Graves’ disease longer than 3 years, FT4 greater than 70. 5 pmol/ L, TPOAb above 360 IU/ ml, and TRAb above 15 IU/ L. In these coses 131 I therapy will be recommended.

Objective To explore the dynamic spiral CT findings of adrenal ganglioneuromas and to evaluate its clinical value.Methods All 7 cases patients with adrenal ganglioneuromas confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation.The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Six of 7 lesions were located in the right adrenal gland,1 in the left.The diameter of the tumors was 3.7—7.5cm,with a mean diameter of 4.6cm.The CT value of the plain scans, AP phases and PVP phases was 16.2—31.7 HU(with a mean value of 24.3 HU),20.9—36.6 HU(with a mean value of 30.2 HU),and 27.4—45.5 HU(with a mean value of 36.0 HU),respectively.The masses were well defined and showed a tendency of wedging into the space between the adjacent organs and structures and encasing the large vessels such as IV,but didn't compress or occlude them.Conclusion The dynamic SCT features of adrenal ganglioneuromas were obvious,dynamic SCT scans could suggest the diagnose.

Objective To analyze the distribution of main lesion areas in pulmonary fibrosis induced by paraquat in rats by means of radiographic imaages and varied CT value by using MicroCT. Methods A total of 15 male Sprague Dawley rats were randomly (random number) divided into control group and paraquat poisoned group. group. The rats in exposure group were treated with dilute solution of paraquat (4mg/ mL) in dose of 14mg/kg injected intraperitoneally, and the rats in control group were treated with the same volume of saline instead. The lung tissues of all rats were scanned in vivo by using MicroCT on the 3rd, 7th , 14th and 28th days after paraquat or saline administration, respectively. The data from scanned images, rates of observable signs of pulmonary fibrosis and average CT value variation in given regions (region of interest, ROI) were compared between groups and different durations after poisoning by using statistical methods as one factor analysis of variance (t-test). Results Compared with the control group, the rats with acute paraquat poisoning appeared varying degrees of the signs of pulmonary fibrosis. Most of the lesion areas predominantly spread over the lateral regions of the lower lobe of lung, and appeared mainly one week after paraquat poisoning. The opacity of lung shadow seen on the radiograph was significantly increased with time extended after exposure to PQ as a consequence of CT value variation in ROI, and there was no difference in the development of pulmonary fibrosis between right lung and left lung ( P > 0. 05), but there were differences in the extent of fibrosis at different areas in lung (P <0.05 or P < 0.01). Conclusions The signs of pulmonary fibrosis predominantly appeared one week after poisoning. The opacity of lung shadow was increasing gradually during the course of pulmonary fibrosis developed in rats in paraquat poisoning group, and lesion areas predominantly spread over the lateral regions of the lower lube of lung.

OBJECTIVE: To observe the clinical effect of 5% D-fructose injectio on energy supply in surgery patients. METHODS: By setting 5% glucose injectio as control,the influence of 5% D- fructose injectio on blood sugar level,liver and kidney function indices was detected.RESULTS: 5% D-fructose injectio did not influence liver and kidney functions, serum uric acid and RESULTS: of routine examination of blood and urine.Compared with control group, the change of blood sugar level in experiment group was slighter.CONCLUSION: 5% D-fructose injectio is effective and safe for energy supply in surgery patients.

OBJECTIVETo prepare a mouse model of asthma by sensitizing and challenging with house dust mite allergen Derp and evaluate its reliability by measuring airway allergy inflammation and airway responsiveness.

METHODSTwelve C57BL/6J mice were randomly divided into two groups: control and asthma model. Mice of the asthma model group were sensitized by intraperitoneal injection of house dust mite allergen Derp on the first and tenth days of the experiment. From the 17th day, the mice were challenged by intranasal Derp, once every other day, seven times. The control group was treated with normal sodium instead of Derp. Twenty-four hours after the last challenge, airway responsiveness was evaluated. Bronchoalveolar lavage and histological examination of the lung were performed.

RESULTSAirway resistance increased and dynamic lung compliance decreased significantly in the asthma model group as compared to the control group (P<0.01). When airway resistance increased by 25% and dynamic lung compliance decreased by 15%, the required metacholine concentration in the asthma model group was significantly lower than that in the control group (P<0.01). In the bronchoalveolar lavage fluid of the asthma model group, the number of total cells, absolute number of eosinophils (EOS) and the percentage of EOS in the total cell were significantly higher than those in the control group (P<0.01). Pulmonary pathological scores in the asthma model group were significantly higher than those in the control group (P<0.01). The asthma model group showed ultrastructural changes of bronchial and pulmonary arterioles. Goblet cells, mastocyte granules, and increased mucus were observed in the lung tissues of the asthma model group.

CONCLUSIONSA mouse model of asthma was prepared by sensitizing and challenging with house dust mite allergen Derp, with the characteristics of airway allergy inflammation and airway hypersensitivity reaction.

Airway Resistance ; Animals ; Arterioles ; ultrastructure ; Asthma ; etiology ; pathology ; physiopathology ; Disease Models, Animal ; Eosinophils ; pathology ; Female ; Lung ; pathology ; ultrastructure ; Lung Compliance ; Mice ; Mice, Inbred C57BL ; Pyroglyphidae ; immunology

Objective To explore whether paraquat (PQ) can induce the formation of neutrophil extracellular traps (NETs) in human peripheral blood.Methods Neutrophils were isolated from healthy human peripheral blood,and the cells were identified by hematoxylin-eosin (HE) strain.The cells were treated with different concentrations of PQ [0 (as control),200,400,600,800,1 000 and 1 200 μmol/L],and the cell viability was measured by cell proliferation and CCK-8 cytotoxicity detection kit,and the median lethal concentration of PQ was selected.The cells were treated with the median lethal concentration of PQ (PQ poisoning group),and the untreated cells were served as the control.Immunofluorescence staining was adopted to evaluate NETs formation.PicoGreen dye was used to determine the quantitative content of circulating free DNA.Western Blot was used to determine the expressions of citrullinated histone 3(H3Cit) and myeloperoxidase (MPO) in the supernatant.Results The purity of neutrophils was about 95％ by HE staining.The cells were treated with different concentrations of PQ,and the result showed that the viability of cells was (58 ± 2)％ with 800 μmol/L PQ for treatment.The immunofluorescence showed that there were few expressions of H3Cit and MPO in neutrophils in the control group,and there was no NETs formation,which was composed of DNA,H3Cit and MPO.Compared with the control group,a large amount of NETs was generated from neutrophils stimulated by 800 μmol/L of PQ.Meanwhile,quantitative result showed that the content of cell free DNA in the supernatant was significantly increased in PQ poisoning group as compared with that of control group (μg/L:2 235 ± 462 vs.561 ± 87,P ＜ 0.01).The protein expressions of H3Cit and MPO in the supernatant were also significantly increased as compared with those of control group [H3Cit protein expression (gray value):0.23 ± 0.03 vs.0.11 ± 0.01,MPO protein expression (gray value):0.47 ± 0.05 vs.0.21 ± 0.04,both P ＜ 0.05].Conclusion 800 μmol/L of PQ can induce the formation of NETs in human peripheral blood.