Cilia ; ultrastructure ; Humans ; Maxillary Sinus ; ultrastructure ; Microscopy, Electron, Scanning ; Mucous Membrane ; ultrastructure

BACKGROUND: Inadequate hyperventilation may trigger cerebrovascular contraction and lead to lowered cerebral perfusion and oxygen supply-demand imbalance.OBJECTIVE: To investigate the influence of hyperventilation on oxygen saturation in the internal jugular vein, difference in oxygen and lactic acid contents between the cerebral arteries and veins in patients with serious traumatic brain injury.DESIGN: Case analysis.SETTING: Department of Anesthesiology, First Hospital Affiliated to Shantou University.PARTICIPANTS: Sixteen patients who received emergency operations in the First Hospital Affiliated to Shantou University between January and July 2002.METHODS: Patients with traumatic brain injury underwent operation under general anesthesia, and the PaCO2 was maintained at 30 mm Hg for 15 minutes by regulating the respiration rate, followed by decrease to 25 mm Hg, maintained for 15 minutes before restoration to 30 mm Hg for 15 minutes. The fractional concentration of inspired oxygen was adjusted to maintain blood PaO2 at around 100-150 mm Hg, and the blood sample was collected from the artery and internal jugular vein 15 minutes after adjustment of PaCO2 for blood gas analysis. The PaO2 was then increased to 200-250 mm Hg by increasing the fractional concentration of inspired oxygen, and the PaCO2 was adjusted from 30 to 25 and then back to 30 mm Hg in the described manner, and the oxygen saturation in the internal jugular vein, difference in oxygen and lactic acid contents between the arteries and the veins were measured.MAIN OUTCOME MEASURES: Influence of blood PaO2 and PaCO2 on oxygen saturation in the internal jugular vein, difference in oxygen and lactic acid contents between the arteries and the veins.RESULTS: Sixteen patients met the diagnostic criteria and completed data collection. The arterial PaCO2 decreased from 30 to 25 mm Hg when arterial blood oxygen pressure increased from 100-150 to 200-250 mm Hg, which leads to obvious decrease of oxygen saturation in the internal jugular vein and obvious increased difference in oxygen content between the cerebral artery and vein. However the absolute value of oxygen saturation in the internal jugular vein was obviously higher at PaO2 of 200-250 mm Hg than that at PaO2 of 100-150 mm Hg, while the absolute value of cerebral arteriovenous difference of brain oxygen content was obviously lower. Compared to the basal level, the arteriovenous lactic acid difference was obviously increased at PaO2 of 100-150 mm Hg,PaCO2 of 30 and 25 mm Hg, and at PaO2 of 200-250 mm Hg and PaCO2 of 25 mm Hg.CONCLUSION: Relatively higher PaO2 (200-250 mm Hg) and mild hyperventilation (PaCO2 of 30 mm Hg) has no obvious effect on brain oxygen supply-demand balance.

To retrospectively analyze the clinical data of 305 cases with apoplectic sequela admitted at our general geriatric nursing ward from January 2000 to December 2011.The subjects were divided into 2 groups:hypoalbuminemia and non-hypoalbuminemia.Advanced age (OR =5.624),chronic heart failure (OR =2.298),conscious disturbance (OR =1.575),dysphagia (OR =1.565),complete bedridden (OR=2.874),pneumonia (OR =3.725) and bedsore (OR =5.336) were risk factors for hypoalbuminemia in the patients with apoplectic sequela.And hyperglycemia(OR =0.066)was a protective factor for it.

Objective To explore the related factors of the relapse of schizophrenics in unwell developed economic areas.Methods To analyze 718 schizophrenics by single and multiple stepwise regression analyses to explore whether relapse of schizophrenia was related to those factors.Results 2.8％ experienced one time relapse, 14.2％ experienced two times relapse and 83％ three times. The rate of schizophrenic relapse was in turn correlated with treatment compliance, treatment intervention, marriage, clinical features, psychological stress,social support, the way of forming disease, medical expenses and condition of access to medical care. Conclusions More attention should be paid to the factors causing schizophrenic relapse and wider measures of prevention and treatment should be taken.

Objective To study clinical effect of oral montelukast therapy in the treatment of 35 children with cough variant asthma.Methods 35 children with cough variant asthma were divided into the control group (17 cases)and observation group(18 patients).The control group was given oral procaterol hydrochloride,patients in the observation group were given oral montelukast sodium on the basis of taking procaterol hydrochloride.Results The total effective rate of the observation group (94.44%) was significantly higher than the control group (64.71%),the difference between the two groups was statistically significant (χ2 =4.832,P <0.05).In the two groups before and after treatment the maximum peak expiratory flow rate change had no statistically significant difference (P >0.05).After treatment,the FEV of the observation group (12.81 ±0.34)L was higher than that of the control group(2.32 ±0.45 )L,the difference between the two groups was statistically significant(χ2 =3.648, P <0.05).The FVC of the observation group (3.44 ±0.21)L was higher than the control group (2.98 ±0.15)L, the difference between the two groups was statistically significant (χ2 =7.417,P <0.05).The FEV1 /FVC of the observation group (68.31 ±6.44)was higher than that of the control group (58.46 ±6.49),the difference between the two groups was statistically significant (χ2 =4.505,P <0.05).The cough relief time of the observation group (4.45 ±1.32)d was lower than the control group (6.33 ±2.46)d,the difference between the two groups was statistically significant (χ2 =3.151,P <0.05).The cough symptoms disappear time of the observation group (7.63 ±1.96)d was shorter than the control group (10.61 ±1.84)d,the difference between the two groups was statistically significant (χ2 =4.639,P <0.05).In the two groups before and after treatment the liver and kidney function and blood,urine routine had no significant changes.No adverse reaction occurred during the treatment.Conclusion Steiner conven-tional therapy combined with montelukast in the treatment of children with cough variant asthma can rapidly relieve symptoms of cough,significantly improve lung function,reduce the recurrence rate,no adverse reactions,and signifi-cantly improve clinical efficacy,it is worthy of clinical application.

OBJECTIVE:To get a clear idea about current situation and trend of the application of eye drops in hospital of Shanghai so as to provide the information for rational clinical application and development of new preparations.METHODS:The kinds and amount of commercial eye drops,used in 47 hospital in Shanghai for the years 1997～2001,were analysed and evaluated.RESULTS & CONCLUSION:The amount of consumption of eye drops was increased year by year.The new type with good quality was received by clinical physicians.

Therapeutic hypothermia is believed to improve neurodevelopment outcome of infants with moderate-to-severe hypoxic-ischemic encephalopathy(HIE),however,the severe brain injury and neurologic sequelae still can be observed in some infants received therapeutic hypothermia.Optimal monitor and management of systematic complications presented by infants during cooling treatment are necessary for improvement of overall outcome.Therefore,it is essential to understand the functional change of each system of the whole body,to adapt adequate diagnostic methods and to train multidisciplinary staffs to monitor and manage moderate-to-severe HIE infants during therapeutic cooling.With the development of therapeutic hypothermia,it is currently considered as a standard of care for infants with moderate-to-severe HIE.It is recommended that any neonatal intensive care unit(NICU) using routinely therapeutic hypothermia to reference the national or international benchmarking protocols in order to improve the medical quality and prognosis of infants.

To date, three techniques of total spondelyctomy were used for spinal tumor, including piecemeal technique, eggshell technique and total en bloc spondelyctomy, and each has specific features and indications. Due to limitations of technique, piecemeal technique and eggshell technique are gradually replaced by total en bloc spondelyctomy in treatment of spinal tumor. Moreover, with technical development, application of total en bloc spondelyctomy in treatment of spinal tumor becomes more rigorous and standard. However, it is controversial about its indications and surgical approach. Postoperative spinal stability reconstruction is achieved through various methods according to different conditions.

OBJECTIVE: To analyse the situation of use of therapeutic drugs for benign prostate hyperplasia(BPH) in hospitals of Shanghai and to make OBJECTIVE: evaluation as reference for production,sale and consumption departments.METHODS: To investigate the BPH drugs used in 47 hospitals of Shanghai during the 1999 - 2001 period in respect to the amunt of consumption, kinds, sum of money of consumption, DDDs and clinical evaluation .RESULTS: Consumption of BPH drugs was increasing in recent years, but kinds of drugs had no obvious change, major drugs for BPH were Finasteride, Tamsulosin and Prostat .CONCLUSION: Therapeutic drugs for BPH are common drugs, but price is very expensive.To speed up the reseach and development of drugs in our country and to advocate the use of domestic products are suggested.