Objective To observe the removal of tumor necrosis factor-? (TNF-? ), interleukin-6 (IL-6) and endothelin-1 (ET-1) in continuous renal replacement therapy (CRRT) on hemorrhagic fever with renal syndrome (HFRS) patients, and investigate the effect of inflammatory mediators on HFRS. Methods A total of 40 patients with moderate or more severe HFRS were divided into two groups randomly. Continuous venous-venous hemofiltration (CVVH) was applied to the 20 cases in CVVH group, and hemodialysis (HD) was applied to the 20 cases in HD group. The levels of TNF-? and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA), and ET-1 level was measured by radioimmunoassays (RIA). Results ① In comparing CVVH and HD groups, the days of oliguria (3.0?2.1, 6.0?3.4), incidence of complications (25%, 40%), and mortality (15%, 25%) had significant differences (P0.05). ④ In CVVH group, IL-6 and ET-1 could be detected constantly in filtrate, but TNF-? was not detectable. TNF-?, IL-6 and ET-1 were not detectable in dialysate. Conclusion Continuous blood purification can remove plasma inflammatory mediators. Therefore, it is helpful in recovering renal function, improving the prognosis of HFRS, and decreasing complications and mortality. CVVH is one of the best methods to treat HFRS.

Objective To study the application of negative pressure drainage on nasal septum reconstructomy by endoscopy.Methods Totally 80 patientswith nasal septum deviation in our hospital from May 2014 to March 2015 were randomly divided into the observation group and the control group.All patients were given nasal septum reconstructomy by endoscopy,and patients of the observation group were given negative pressure drainage after surgery while the patients in control group were given traditional nasal cavity filling postoperatively.Observed the subjective symptoms,degree of disease and complications of patients 12 hours and 24 hours after surgery.And the clinical curative effect of the two groups were compared and analyzed 1 week after the surgery.Results The subjective symptoms of the observation group was obvi-ously better than the control group 24 hours after the surgery with statistically significant difference (P <0.05).And the degree of disease in observation group had significantly improved,and the nasal mucosa edema ratio of level 0 was 40%,which was significantly higher than 10% in the control group (P <0.05).The total effective rate was 97.50% in the observation group 1 week after surgery and it was 80% in the control group,and there were significant difference between the two groups (P <0.05).The incidence of complications in the observation group was 2.50%,which was significantly less than 20% in the control group (P <0.05).Conclusion The application of negative pres-sure drainage on nasal septum reconstructomy by endoscopy could effectively relieve the pain of patients and reduce complications,and its prognosis effect is better.

OBJECTIVE: The objective of this study was to evaluate the effect of nasal packing, septal suture technique and vacuum sealing drainage (VSD) after septoplasty. METHOD: Ninety patients of nasal septal deviation in Combination with outfracture of the inferior turbinates who had received septoplasty were selected in this study. The patients were allocated into three groups, with thirty in each: for packing group, marcel materials were used for nasal packing after septoplasty; for suturing group, septal suture technique was performed after septoplasty; for VSD group, one drainage tube was used for negative pressure sucking after septoplasty without nasal packing. Postoperative signs and symptoms were compared between three groups. The comfort degree assessment included headache and nasal obstruction were evaluated by using visual analogue scale (VAS) at the 12th hour and 24 hour after operation. The edema in nasal cavity, hemorrhage. abscess,adhesive and healing rates after operation were compared among three groups. RESULT: The VAS score of headache and nasal obstruction and the severity of patient's conditions were significantly less in septal suture group and VSD group than that in packing group at the 12th and 24th hour after operation. The mucosa edema of nasal cavity was significantly slighter in septal suture group and VSD group than that in packing group at the third day after operation. The healing rates and number of complications are better in septal suture group and VSD group than those in packing group at the 7th day after operation. There were no hemorrhage or abscess in VSD group. CONCLUSION Septal suture technique and VSD after septoplasty can significantly relieve the distress of patients and reduce the healing time of mucosa in nasal cavity without increasing the risk of complications.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nasal Obstruction ; surgery ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; Negative-Pressure Wound Therapy ; methods ; Postoperative Period ; Rhinoplasty ; methods ; Suture Techniques ; Young Adult

Interdisciplinary can be acted in any stages of researching procedure.The interdisciplinary process research thinking were addressed including how to builds variables,which are depth and width,fixed discipline or not,and also to reflect the collaboration level of interdisciplinary in certain period.By this quantity evaluation mode building,it will useful for the interdisciplinary research in the future,especially in medical and life science fields.

ObjectiveTo investigate the effects of platelet derived growth factor (PDGF) on brain cell apoptosis rate and serum neuron-specific enolase (NSE) concentration after hypoxic-ischemic brain damage (HIBD) in neonatal rats. MethodsForty-eight HIBD models of 7-day old neonatal Wistar rats were established and then divided into two groups randomly:PDGF group and normal saline control group (n =24 in each).Another 24 neonatal Wistar rats were taken into the sham operation group.The treatment group received intraperitoneal injection of PDGF-BB (50 ng/kg) once,while the other two groups received normal saline at the same time.In each group,rats were randomly sacrificed immediately at 12,24 and 72 hours after injection (n=8).The serum of rats were reserved for NSE concentration determination by enzyme linked immunosorbent assay,and the right brains of the sacrificed rats were used to prepare brain cell suspension for neurocyte apoptosis rate examination by flow cytometry.Mono-variate analysis and q-test were performed for statistical analysis. Results(1) The brain cell apoptotic rates of treatment group [ (6.09 ± 0.70)％,(9.67 ± 1.52) ％ and (14.15±1.52)％] and control group [(8.00± 1.10)％,(11.45±2.42)％ and (22.90±2.03) ％] were significantly increased compared to that of sham group [(2.11 ± 0.54)％,(2.34 ±0.46)％ and (2.21±0.49)％] at all time points (all P＜0.01 or ＜0.05),the apoptotic rate of treatment group was lower than that of control group (P＜0.01 or ＜0.05).Statistical differences were found among the three groups at 12,24 and 72 hours (F =39.01,66.60 and 194.20respectively; P＜0.01).(2) Serum NSE concentration was significantly increased in the treatment group [(8.43 ± 0.17) μg/L,(6.73 ± 0.16) μg/L and (6.12 ± 0.13) μg/L] and control group [(10.04±0.19) μg/L,(9.330.15) μg/L and (8.36 ± 0.16) μg/L] than in the sham group [(4.22±0.53) μg/L,(3.96±0.60) μg/L and (3.59±0.55) μg/L] at all time points,and it was significantly lower in treatment group than in control group (P＜ 0.01).Statistical difference was found among three groups at 12,24 and 72 hours (F=371.25,245.61 and 236.22 respectively,P＜0.01). ConclusionsPDGF might have neuroprotective effect,which could inhibit apoptosis of neural cells and decrease the serum NSE concentration.

Objective To evaluate the effect of dexmedetomidine on acute kidney injury after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods One hundred patients of both sexes with rheumatic heart disease,aged 32-64 yr,weighing 46-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association class Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were divided into 2 groups (n =50 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine was intravenously infused in a loading dose of 1 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.4 μg · kg-1 · h-1 until 24 h after operation in group D,while the equal volume of normal saline was given in group C.The urine output per hour during the postoperative 48 h period was recorded.At 6,12,24,36 and 48 h after operation,blood samples were collected from the median cubital vein for determination of serum creatinine levels.The development and severity of acute kidney injury were determined according to the urine output and serum creatinine level.Results Compared with group C,the incidence and severity of acute kidney injury were significantly decreased in the postoperative 48 h period in group D (P＜0.05).Conclusion Dexmedetomidine infused in a loading dose of 1 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.4 μg · kg-1 · h-1 until 24 h after operation can reduce the development and severity of acute kidney injury after cardiac valve replacement with CPB in patients.

Objective To study the relationship between renal morphology and renal function,and to assess the value of CT as a criterion to grade renal function.Methods Enhancement CT were performed in 89 patients with no local renal disease whose split renal glomerular filtration rates(GFR)were measured by renal dynamic imaging with ~(99)Tc~m-DTPA.The 178 kidneys were divided into normal renal function,mild and severe renal impairment groups according to renal function.Differences between three groups respect to the mean thickness of renal cortex and parenchyma were assessed by ANOVA.Using Pearson's correlation test,the correlation between the renal cortex,parenchyma thicknesses and renal GFR were examined.The value of CT in predicting renal function was assessed by using ROC analysis.Results The renal cortex thicknesses of normal renal function,mild and severe renal impairment groups were(5.9?1.1),(4.6? 1.1),and(3.3?1.0)mm respectively,and the renal parenchyma thicknesses were(26.3?4.2), (21.3?4.6),(16.2?4.6)mm.There were significant differences of renal cortex,parenchyma thicknesses between 3 groups(cortex F=54.78,P

Because of the population aging,the increase of the stroke patients and the need for rehabilitation,the treatment only in the rehabilitation department of the hospital is far from the satisfaction of people's demands of the service of rehabilitation.It is important to extend the community-based rehabilitation.Compared with the rehabilitation in hospitals,it is more economy,efficiency and convenience for stroke patients in community-based rehabilitation services,and further improve the rehabilitation effect of stroke patients.

Objective To evaluate the feasibility and clinical value of combined clonidine and sleep-deprivation induced seizures for ictal brain SPECT imaging in patients with epilepsy. Methods Fiftytwo epilepsy patients were given oral clonidine plus sleep-deprivation to induce seizures with video-electroencephalogram (VEEG) monitoring. Forty-seven patients were selected as control group, whose seizures were induced by sleep-deprivation only. 99Tcm-ethylcysteinate dimer (ECD) was injected within 30 s since a clinical sign and/or a typical EEG discharge of epilepsy was recognized. Brain SPECT was performed 30 min after 99TcmECD injection. X2-test was performed by using software SPSS 10. 0. Results One to two hrs after oral intake of clonidine plus sleep-deprivation, 75% (39/52) patients were induced seizures, including 92.3% (36/39) with subclinical seizures and 7.7% (3/39) with clinical seizures. Ictal brain SPECT localized the lesions with high uptake of 99Tcm-ECD in 37 (94.9%) patients. In control group, 38.3% ( 18/47) were induced epileptic seizures, including 77.8% (14/18) with subclinical seizures and 22.2% (4/18) with clinical seizures. The induction rate of epileptic seizures in clonidine plus sleep-deprivation group was significantly higher than that of control group (X2 = 13.614, P ＜ 0.01 ). However, there was no significant difference in clinical seizures between the two groups (X2 = 1.253, P ＞ 0.05 ). Conclusions The combination of oral intake of clonidine and sleep-deprivation could increase the induction rate of epileptic seizures and it is effective for epilepsy SPECT imaging.

Objective:To compare the sonographic features of clinical lymph node negative (cN 0) stage papillary thyroid microcarcinoma (PTMC) and non-PTMC, and improve the early diagnosis of cN 0 stage PTMC. Methods:The clinical data of 223 patients with papillary thyroid carcinoma from January 2015 to December 2017 in Dalian Municipal Center Hospital were retrospectively analyzed. Preoperative ultrasonography of all patients showed lymph node negative, and all patients received radical thyroidectomy. Among them, PTMC was in 143 cases (tumor diameter ≤1 cm, PTMC group), and non-PTMC in 80 cases (tumor diameter >1 cm, non-PTMC group). The sonographic features, including echogenicity, boundary, morphology, calcification, posterior echo attenuation, blood flow and ratio of length and width were compared between 2 groups.Results:There were no significant differences in the incidences of unclear boundary, irregular shape and posterior echo attenuation between the two groups ( P>0.05). The incidences of extremely low or low echo and ratio of length and width ≥1 in PTMC group were significantly higher than those in non-PTMC group: 88.1% (126/143) vs. 67.5% (54/80) and 37.8% (54/143) vs. 7.5% (6/80), the incidences rate of calcification and peripheral or internal blood flow were significantly lower than those in the non-PTMC group: 55.9% (80/143) vs. 72.5% (58/80) and 49.0% (70/143) vs. 77.5% (62/80), and there were statistical differences ( P<0.01 or <0.05). Conclusions:The ultrasonographic features of cN 0 stage PTMC and non-PTMC are different.