Objective To investigate the effect of different modes of one-lung ventilation ( OLV) on respiratory mechanics, hemodynamics and arterial oxygen tension ( PaO2) in pediatric patients. Methods Thirty-four ASA Ⅰ - Ⅱ patients (14 male, 20 female) aged 2-10 yr, weighing 8-26 kg undergoing abdominal surgery or operations on extremities were enrolled in this study. The patients were premedicated with intramuscular phenobarbital 2-3 mg ? kg-1 and atropine 0.015 mg ? kg-1 . In the operating room the patients were given intramuscular midazolam 0.25 mg? kg-1 and ketamine 2.5 mg ? kg-1 before intravenous line and EGG, NIBP and SpO2 monitoring were established. Anesthesia was induced with intravenous fentanyl 3-5 ?g kg-1 and vecuronium 0.1 mg? kg-1 and maintained with isoflurane inhalation supplemented with intermittent iv boluses of fentanyl and vecuronium. In patients aged over 5 yr Univent (Fuji Corpi) was inserted and left main bronchus was blocked during OLV. In patients less than 5 yr ordinary tracheal tube was inserted and was advanced into right main bronchus during OLV. Correct positioning of the tube was checked by fiberoptic bronchoscopy or auscultation. The test consisted of three steps : firstly two-lung ventilation (TLV) with volume-control mode; secondly OLV with volume-control mode;lastly OLV with pressure-control mode. During first and second step VT was set at 8-10 ml kg-1 and respiratory rate was adjusted to maintain PETCO2 between 4.5-6.0 kPa. During the third step (OLV with pressure-control mode) the inspiratory pressure was set according to the plateau pressure during step 1 and 2 (volume-control mode). Each step was maintained for 25 min before respiratory mechanics , hemodynamics and PaO2 were measured and recorded.Results During OLV with volume-control mode (second step) , peak pressure (Ppeak), plateau pressure (Pplat) and airway resistance (Raw) were significantly higher but dynamic compliance was significantly lower, cardiac output (CO) and stroke volume (SV) were significant lower but systemic vascular resistance (SVR) was significantly higher and PaO2 was significantly lower than those during first step (two lung ventilation with volume-control mode) (P

The etiological agent of severe acute respiratory syndrome (SARS) was identified as a new coronavirus, termed SARS-CoV. Establishment of an efficient and sensitive diagnostic system of SARS-CoV genetic materials is crucial for SARS control. In this study, we quantified SARS-CoV mRNAs in both infected cell culture lysate and in supernatant by using Real-time quantitative revere transcription-PCR based on EvaGreen鈩?dye and Taqman-MGB probes. For extensive evaluation of sensitivities and specificities, 13 pairs of primers and 4 probes were designed based on different genes of SARS-CoV. Glyceraldehydes-3-phosphate dehydrogenase (GAPDH) was selected as the internal control gene. Results showed that S-gene-specific PCR was the most sensitive for detection, but because of its sequence variability in the different viral strains, primers and a probe based on the N gene were suitable substitutions. Meanwhile, we found the mRNA concentrations in cell culture lysates were much higher than in cell supernatant and facilited more sensitive detection of the SARS-CoV.

Background In the past few decades,the balance of Th1/Th2 is often used to explain the immune mechanisms of fungal infection and fungal disease.More recently,a novel subset of CD4+ effector Th cells has been found to participate in anti-fungal infection response.However,whether Th17 is involved in the immune response in fungal keratitis is unclear up to now.Objective Present study was to investigate the expression change of Th17 type cytokine and its specific transcription factor,retinoid-related orphan nuclear receptor gamma t (RORγt),in the cornea of Fusarium solani keratitis.Methods Ninety-six clean BALB/c mice were divided into Fusarium solani keratitis model group and control group by randomized digital table.Fusarium solani keratitis models were established by epikeratophakia-assisted corneal epithelial erasion and interlayerly injection of 5 μl (1 × 106 CFU/ml) Fusarium solani solution in the right eyes,and the equal volume of PBS was injected in the same way in the control group.10％ KOH wet film was used to examine the fungal hyphea and funga strain was identified by inoculation.The corneas were examined under the slit lamp microscope 1 day,3,5,7 days after modeling and the inflammatory response was scored based on the criteria of Wu and Hu.The histopathological examination of corneas was performed in the time points above.Real time fluorescence quantitative PCR was used to detect the expression levels of interleukin-17 (IL-17) mRNA and RORγt mRNA in the corneas.The expression of IL-17 protein in the corneas was detected by ELISA.The use and raise of the mice followed the Statement of Association for Research in Vision and Ophthalmology.Results The inflammatory scores were 3.2±0.8,6.6± 1.1,9.4± 1.1 and 6.8±0.8 in 1 day,3,5,7 days after modeling,showing a significant difference among them (F =89.786,P =0.010).The inflammatory scores were higher in the third and seventh day than that in the first day (P＜0.05),but they were significantly lower than that in the fifth day (P＜0.05).The infiltration of inflammatory cells showed a coincident tendency with the score.The expressing levels of IL-17 mRNA (2-ΔΔCt) in the corneas were 4.12±0.73,20.72±1.81 and 14.16±1.88 in 3,5,7 days after modeling,with statistically significant differences in comparison with those in the control group (P＜0.01),and the expression level was significantly higher in the fifth day than those in the first,third and seventh day in the model group(P＜0.01).The expression levels of IL-17 protein (ng/g) were significantly increased 1 day,3,5,7 days in the model group compared with the control group (P＜0.01).A similar change was found in the expression of RORγt mRNA to that of IL-17 mRNA.Conclusions Expressions of IL-17 and its transcription factor RORγt upregulate in the fungal keratitis and has an association with inflammatory degree,which suggests that Th17 subset may play an important role in the immune responses of fungal keratitis.

Objective To build the cohort of drug resistance and analyze treatment efficiency of AIDS patients and situation of drug resistant mutations among HIV-1 infected individuals.Methods A cohort of 116 HIV-1 infected patients was built and their treatment progress were acquired once every 6 months.At the sanle time CD4+ T cell counts and HIV-1 viral load were measured and genotyping for drug resistance was determined by a home brew nested PCR.Results The CD4+ T cell count(470±251/ml)was higher than that before treatment in patients who were treated by AZT/DDI/NVP or D4T/DDL/NVP.The viral load was lower than that before treatmenL The drug resistant mutation frequency increased gradually along with treatment.The CD4+ T cell count was decreased and viral load was increased and the prevalence of drug resistant mutation was increased in the patients who changed regimens to AZT/3TC/NVP or D41/3TC/NVP.Only one primary mutation that was resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs)was detected in the naive patients.The cross-resistant mutation was detected in two patients after 6 months treatment. The intermediate resistance to lopinavir(LPV) was detected after 12 months treatment.The prevalence of high-grade resistances to NNRTIs was increased obviously,and the prevalence of multi-resistance and cross-resistance was detected in 5 patients after 36 months treatment.Conclusions The prevalence of primary mutation was rare in naive HIV-1 infected patients.The prevalence of drug resistant mutation was inereased gradually along with treatment.Ahhough few regimens were available,the treatment effect could last relatively long period of time if patients keep taking medicine stably.The regimens could be changed according to the results of drug resistant test.

Objective To investigate the expression of macrophage migration inhibitory factor(MIF) in renal tissue of children with Henoch-Schonlein purpura nephritis(HSPN),and its correlation with clinical indexes and pathological changes,and to explore its effect on the pathogenesis of HSPN.Methods According to the clinical manifestation,60 children with HPSN were divided into only purpura group,mixed group and HSPN group.MIF concentration of Henoch-Schonlein purpura(HSP) groups and healthy control group were detected with enzyme linked immunosorbent assay(ELISA).MIF protein expression and the marker of human macrophage(CD68) in renal tissues of HSPN and normal control group were detected with immunohistochemistry method.The total urine protein for 24 hours and urinary N-acetyl-beta-D-glucosaminidase (NAG) level were detected with laboratory routine method.Results MIF concentration in mixed group and HSPN group were significantly higher than that in only purpura group and healthy control group(Pa

Objective:To investigate the influence of clinical outcomes and the risk factors of poor prognosis for preoperative nutritional risk in gastric cancer patients.Methods:A prospective study was performed in 140 patients with gastric cancer and the nutritional risk screening 2002 (NRS 2002) was done.The influence of preoperative nutritional risk on postoperative complications,hospital stay,ICU stay,hospital expenses,60 days readmission and mortality was analyzed,and the risk factors of perioperative complication were identified by univariate and multivariate analysis.Results:The significant difference (NRS 2002 ≥ 3 group vs.NRS 2002 ＜ 3 group) was observed in the rates of overall postoperative complications,pulmonary infection,overall hospital stay and postoperative hospital stay (P ＜ 0.05).The rates of anastomotic fistula,pleural effusion,60 days readmission,60 days mortality and hospitalization expenses in NRS 2002 ≥ 3 group were higher than that of NRS 2002 ＜ 3 group,but there were no differences between the two groups (P ＞ 0.05).By univariate and multivariate analysis,preoperative high cholesterol levels and preoperative nutritional risk are the risk factors of poor prognosis and postoperative complications.Conclusion:Preoperative high cholesterol levels and preoperative nutritional risk are independent risk factors of postoperative complications.

This study aims to analyse the value of CODEHOP RT-PCR in the detection of Flavivirus. According to the amino acid sequences of polyproteins of different flaviviruses published in GenBank, a pair of primers was designed using the CODEHOP method. One-step RT-PCR was used to detect Japanese encephalitis virus strain JEV1201, Dengue virus strain JKD001, and yellow fever virus vaccine YV6161. BLAST analysis and phylogenetic analysis were performed after the RT-PCR products of nucleocapsid genes were sequenced. The results showed that this method could amplify Flavivirus specifically, and the size and sequence of the target fragment accorded with the anticipated result. JEV1201 had the highest homology to Japanese encephalitis virus strain YL2009-4/YC2009-3, belonging to the branch of the phylogenetic tree of Japanese encephalitis virus strains. JKD001 had the highest homology to Dengue virus strain DENV-2/ID/1022DN/1975, belonging to the branch of the phylogenetic tree of Dengue virus strains. YV6161 had the highest homology to Yellow fever virus strain 17D, belonging to the branch of the phylogenetic tree of Yellow fever virus strains. In conclusion, the method of CODEHOP RT-PCR can be effectively used to detect, identify, and phylogenetically analyse Flavivirus.
DNA Primers ; genetics ; Flavivirus ; classification ; genetics ; isolation & purification ; Flavivirus Infections ; virology ; Humans ; Molecular Sequence Data ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Viral Nonstructural Proteins ; genetics

As an important part of the hierarchical medical system in China ,urban secondary hospitals play as a pivot between tertiary hospitals and community healthcare centers.By describing the overall development status of such hospitals in China ,the paper discussed the problems existing in the development of urban secondary hospitals and put forward strategies in the hope of providing reference for the transformation of these hospitals .

Objective: To optimize the formula of compound asiaticoside gel plasters, and determine the optimal preparation process. Methods:Using the initial adhesion, viscosity and appearance as the indices, the gel plasters were evaluated by orthogonal design in order to study the effects of various base ratios on the preparation and screen the optimal formula and preparation process. Re-sults:The optimal formula was dihydroxyaluminium aminoacetate∶EDTA∶glycerol∶CMC-Na of 0. 25∶0. 05∶45∶1. Conclusion: Com-pound asiaticoside gel plasters with the optimal formula and preparation technique show good adhesion and uniformity, which can meet the need of large-scale production.

Objective To understand the children health care and the prevention of lead pollution in Panyu in the future by re-search on the detection result of blood lead from Panyu children during 2011 and 2012.Methods The detection of whole blood lead was by atomic absorption spectrometer from body examination in 6 308 children in Panyu Center Hospital be-tween 2011 and 2012:①The blood lead result from assigned children were divided into five age groups:infancy group (1~12 months,1 511 cases),toddler age group (1~2 years,1 558 cases),preschool age group (3~6 years,1 704 cases),school age group (7~11 years,1 076 cases)and adolescence group (12~18 years,459 cases).②Based on different age group,each group was separated by male and female.③According to the detection year,each group was also put into 2011 and 2012 re-spectively.Results The overall level of children blood lead in Panyu,Guangzhou in 2011 and 2012 was 37.01±29.18μg/L, and the total poisoning rate was 1.2 9%.Along with the growth of age,the overall level of children blood lead was in up-wards trend but the poisoning rate kept in a stable level beginning from infant stage.The blood lead level of boys in Panyu was 38.87±30.18μg/L,and the poisoning rate was 1.91%;the blood lead level of girls was 34.13±27.32μg/L,and the poisoning rate was 1.29%.The blood lead levels and the poisoning rates of boys were higher than girl’s in most of age groups.Conclusion Compared with other big cities like Guangzhou,the blood lead level of children in Panyu was declined but it’s not the standard performance,and there’s a certain extent of lead pollution.So in addition to reinforce pollution con-trol from government,parents and children should enhance the knowledge,education and precaution of lead poisoning.