Objective To investigate the effects of high frequency oscillatory ventilation (HFOV)combined with inhaled nitric oxide(iNO) on neonates with severe meconium aspiration syndrome(MAS).Methods Sixty newborn infants with severe MAS admitted to the neonatal intensive care unit of Shenzhen Children's Hospital from Oct 2008 to May 2011 were included for this study.All of them needed mechanical ventilation after birth and oxygenation index (OI) ＞ 30.According to the different ventilation modes,they were randomly divided into conventional mechanical ventilation (CMV) group,HFOV group and HFOV combined with iNO (HFOV + iNO) group,each group had twenty neonates.OI and the rate of air leak and pulmonary hypertension in each group were compared.Results Ventilation after 24 h,OI of HFOV group and HFOV + iNO group were significantly decreased as compared with CMV group (19.0 ± 4.5 vs 11.0 ± 5.3 vs 25.0 ± 7.1,P ＜ 0.05).In HFOV + iNO group,the obvious decline of OI(from 36.0 ± 7.4 to 24.0 ± 5.2) were observed at four hours after treatment.The rate of air leak in HFOV and HFOV + iNO groups was both zero as compared with CMV (5/20,25％).The rate of pulmonary hypertension in HFOV + iNO group was zero and the HFOV group was 30％ (6/20),the CMV group was 40％ (8/20).Conclusion HFOV combined with iNO was preferred treatment for neonates with severe MAS,and they have synergistic effect.

ObjectiveTo search for the effect and safety of urokinase (UK) in different dosage on acute cerebral infarction.Methods80 patients suffering from acute cerebral infarction were randomly divided into two groups. Group A received UK 0.75 MU intravenously within 30 min. Group B received UK 1.0～1.5 MU intravenously within 30～45 min. ResultsThe neurological deficits scores was improved in both groups. There was no significant difference between group A and group B(P>0.05). The total effective rate and significant effective rate was 82.5% and 60.0% in group A respectively, but those were 87.5% and 65.0% in group B respectively(P>0.05). More hemorrhage happened in group B. ConclusionThe UK in small dosage is effective and relatively safe in treatment of acute cerebral infarctions.

Objective To investigate the effect of pentazocine combined with midazolam on intubation stress response in slow induction of anesthesia. Mtheods Forty ASAⅠ~Ⅱpatients were divided into two groups. Anesthesia was induced with midazolam 0.03 mg/kg in both groups,and pentazocine 0.8 mg/kg (i.v.) was given in pentazocine group or fentanyl 2 μg/kg (i.v.) in fentanyl group. Five minutes later, 2 mL of 1% decicaine was administered by cricothyroid membrane puncture to facilitate the intubation.The SpO2, circulatory indexes (HR, SBP, DBP, BIS) and sedation level were measured at T0, T1, T2, T3, T4, T5, T6. Results Both pentazocine and fentanyl can inhibit stress responses to tracheal intubation effectively,but pentazocine group is better than fentanyl group on the cardiovascular stability during slow induction of anesthesia. Conclusion Pentazocine 0.8 mg/kg can inhibit stress responses to tracheal intubation effectively with a low incidence of adverse reactions in the slow induction of anesthesia.

To assess whether the Shuxuening injection influences liver function, this paper analyzes the hospital information system (HIS) data from 20 national hospitals. The patients were divided two groups: patients (5 353 cases) using Shuxuening injection acted as the exposed group, then the patients (4 863 cases) not using Shuxuening injection acted as the unexposed group. Take the abnormal changes of alanine aminotransferase and aspartate aminotransferase indexes as the result. Control confounding factors by stratification analysis, classic logistic regression analysis, before logistic regression based on propensity score weighting method and logistic regression based on generalized boosted models (GBM) of propensity score weighted combination of covariate adjustment. Then, the study analyzes the effects of Shuxuening injection on liver function by observing the changes of the indexes. Analysis of the impact of parenterally administered Shuxuening on ALT shows that, before logistic regression based on propensity score, then the regression is -0.232 (P value is 0.017). However, after logistic regression based on propensity score method the regression became -0.150 (P value is 0.370). Whereas, analysis of the impact of parenterally administered Shuxuening on AST shows that, before logistic regression based on propensity score, then the regression is -0.034 (P value is 0.767). However, after logistic regression based on propensity score method the regression became -0.091(P value is 0.538). Thus, propensity score method can control a large number of confounding factors, making the results more close to the clinic. Hence, based on existing electronic medical data, this study didn't find that parenterally administered Shuexuening influences ALT and AST.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Electronic Health Records ; Female ; Humans ; Injections ; Liver ; drug effects ; metabolism ; Logistic Models ; Male ; Middle Aged ; Young Adult

Informed consent right is not just for basic ethical consideration, but is important for protecting patient's right by law, which is expressed through informed consent contract. The appraised individuals of forensic clinical examination have the similar legal status as the patients in medical system. However, the law does not require informed consent right for the appraised individuals. I recommend giving certain informed consent right to the appraised individuals in the forensic clinical examination. Under the contracted relationship with the institution, the appraised individuals could participate in the examination process, know the necessary information, and make a selected consent on the examination results, which can assure the justice and fairness of judicial examination procedure.
Forensic Medicine ; Humans ; Informed Consent ; Patient Participation

Animals ; Forecasting ; Herpesvirus 2, Gallid ; genetics ; physiology ; Marek Disease ; genetics ; metabolism ; virology ; MicroRNAs ; metabolism

The medical equipment on-line bid is a newborn method for bid,which unites the modern computer technology,communication technology and electronic commerce technology. When the on-line bid system is applied,except for the make of comprehensive and standard tender documents,the followings also claim attention: how to correctly open the webpage of video meeting inserter,how to suitably adjust video acoustics,and how to properly adjust video images.

AIM: To discuss the influence of high glucose on the proliferation and ICAM-1 expression of human umbilical vein endothelial cells(HUVEC) within 48 h and to observe the altered effect of high glucose when high glucose and inflammatory stimulator exist at the same time.METHODS: HUVEC were cultured with different concentrations of glucose.The proliferation of HUVEC induced by high glucose was detected by MTT assay.The ICAM-1expression of HUVEC induced by high glucose was assayed by flow cytometry and cell ELISA.The difference of ICAM-1 expression between induced by LPS and by LPS together with high glucose was compared.RESULTS: 25、(45 mmol?L~(-1)) glucose did not inhibit the proliferation of HUVEC within 48 h,and they also had no effect on the expression of ICAM-1.However,when stimulated HUVEC with LPS, the proliferation of HUVEC was extremely inhibited in high glucose groups,and the expression of ICAM-1 increased significantly in those groups.CONCLUSION: In short time,high glucose has no effect on the proliferation and ICAM-1 expression of HUVEC,but when inflammatory stimulation exists,high glucose can inhibit the proliferation and increase the expression of adhesion molecules.

Internet-based tendering system makes equipment purchase convenient,rapid,effective,economical and fair. This system guarantees the legal benefits of the medical organizations and suppliers to the most. At the same time this article introduces some issues that should be noticed by medical organizations and suppliers when they participate the on-line bid.

Objective To explore the chronic effects of mild and moderate iodine excess and iodine restriction on apoptosis of thyrocytes. Methods Wistar rats were exposed to 4 different doses of iodine: 4 μg/d (control), 6 μg/d (1.5 fold iodine excess), 12 μg/d (3 fold iodine excess), and 24 μg/d (6 fold iodine excess) for 1, 2, 4 and 8 months. Some rats treated for 8 months were fed with 4 μg/d iodine for another 3 months. Urinary iodine concentration was monitored by arscnic/cerium catalyzing spectrophotography. Apoptosis was determined by flow cytometry after Annexin V-FTTC staining and uhrastructure assessment under electronic microscope. Cell cycle kinetics was analyzed by flow eytometry after propidium iodine staining. Fluorescent measurement by DCFH-DA probe was used to determine the intracellular reactive oxygen species (ROS) level. Expressions of apoptic proteins were analyzed by flow cytometry and immunohistochemistry. Results Apoptotosis rate and ROS production in thyrocytes were significantly increased in 3 and 6 fold iodine excess groups after 4 months and 8 months (all P < 0.05), which was reversed with iodine restriction. 6 fold iodine exposure was proved to cause a reduction of cells in GOG1-phase (64% and 67% vs 80%, both P < 0. 05) and a concomitant accumulation in S-phase (5% and 6% vs 3%, both P <0.05) after 4 months and 8 months. Expressions of Fas, FasL and TRAIL proteins in 3 and 6 fold iodine excess groups after 8 months were increased by 2 to 4 times compared with control group and did not return to normal after iodine restriction. Bcl-2 and Bax remained constant. Positive correlations were observed among iodine amount, apoptosis rate and ROS level in 6 fold iodine excess group after 8 months (r = 0. 637-0.790, P < 0.01). Conclusion Chronic iodine excess results in thyrocyte apoptosis due probably to generation of ROS.