Burns, Inhalation ; complications ; Humans ; Male ; Middle Aged ; Nitric Acid ; adverse effects ; Pulmonary Edema ; chemically induced ; therapy

Objective To investigate the effect of sedation on respiratory mechanic dynamics, intrapulmonary shunt fraction,oxygen metabolism in patients with mechanical ventilation.Method Sixty patients with mechanical ventilation were divided randomly into control group and sedation group.Propofal was administered to patients,whose ramsay scores were kept atⅢorⅣlevels,in sedation group while the equal amount of normal saline was given in control group.Mixed venous blood and arterial blood samples were taken for blood gas analysis in both groups before and at 2 hours after administration.Heart rate,blood pressure,breathing rate and airway resistance all were recorded at the same time.Results There were no significant differences in oxygenation index,blood pressure,blood lactic acid,total lung static compliance and intrapulmonary shunt fraction between two groups before and after administration.Heart rate,respiratory rate,oxygen uptake and airway resistance of patients in sedation group were lower than those in control group,and partial pressure of oxygen in mixed venous blood of patients in sedation group were higher than those in control group.These differences were statistically significant.Conclusions Sedation can decrease oxygen uptake and airway resistance of patients with mechanical ventilation.However,no alteration in the oxygenation index,total lung static compliance and intrapulmonic shunt ratio can be observed.

3 years old than those in ≤3 years old group.The incidence rate of the adverse reaction after SPT was 1.6%(6/384),there were 4 temporary fieber,1 asthma and 1 anaphylactic shock.Conclusions The common allergens are inhalant allergens of dermatophagoides pteronyssinus and dermatophagoides farina in Chongming island.The SPT is more suitable for over 3 years old children with typical anaphylaxis of respiratory symptom and maybe have the potential danger.

There were many factors that affect the chimerism of donor DNA, such as the type of disease, the treatment of the disease, the severity of the disease, the source of hematopoietic stem cells, HLA, GVHD, and so on. This paper mainly discussed the two factors that affect forensic science, including the posttransplantation intervals and sensitivity of the detection method. Forensic workers in forensic practice and paternity and individual identification of allo HSCT recipients, should pay attention to the time after transplantation and the detection method of sensitivity of chimerism. When female recipients received HSCT in the case of male donors, Y chromosome DNA of the donor can be detected from the recipient's hair follicles. The case of biological specimens from the crime scene can not only detect Y chromosome speciifc genetic markers, so as to avoid wrong identiifcation.

Objective To evaluate the diagnosis and management of ectopic pancreas.Methods The clinical data of 62 cases of ectopic pancreas,which were diagnosed by endoscopic uhrasonography (EUS)or pathologic findings between July 2006 and December 2007 were retrospectively analyzed.The cases were divided into 4 groups according to different ways of management.Group A included 37 patients,who were diagnosed as having ectopic pancreas(＜19mm)by EUS only and were followed up via phone call every 3 months.Eight patients in group B were diagnosed by EUS as having submucosal lesions suspected as ectopic pancreas,and underwent operation because of large size or difficulty in diagnosis.Eight patients in group C received operation for other diseases and the eetopic pancreases were found in operation.Group D included 9 patients who underwent surgery due to malignant tumors.ResultsEctopic pancreas were most commonly found as a single lesion in gastric antrum(35/62,56.5%)with mean size of 9.2±5.4 mm.All patients in group A were asymptomatic,of which 10 received followed-up endoscopy and no changes in size of the lesion were found.All patients in group B,C and D were diagnosed as ectopic pancreas pathologically.Conclusion Ectopic pancrea is relatively common and asymptomatic,only part of them could be diagnosed clinically.Carcinoma arising from the ectopic pancreas is rare and lesion of small size diagnosed by EUS could be followed up endoseopieally.

This study was conducted to develop a three-dimension finite element (FE) model of Chinese human neck for dynamic response during impact condition. A 50th percentile adult human in good health was chosen as a model. The 3-D FE model of C1-T1 was constructed by using of SCT scanning technology to get the data of DICOM format, using software Materialisc mimics, Pro-E to achieve three-dimension reconstruction, and using software TrueGrid to mesh. The model was composed of cervical vertebra, discs, facet joints, ligaments and muscles, which consisted of 24916 nodes and 15023 elements, including 14626 eight-node solid elements, 19 two-node link elements and 378 two-node cable elements. In LS-DYNA, the dynamic response of human neck under frontal impact was investigated and compared with experimental results so as to validate the model. The method proposed can develop complex FE model with eight-node elements fleetly and accurately in order to make computing more stably. The developed three-dimension FE model was used for dynamic response during impact condition, which may be helpful to studies on the injury of Chinese human neck.
Accidents, Traffic ; Adult ; Biomechanical Phenomena ; Cervical Vertebrae ; diagnostic imaging ; injuries ; physiology ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Models, Biological ; Neck ; physiology ; Stress, Mechanical ; Tomography, Spiral Computed ; Whiplash Injuries ; etiology ; physiopathology

OBJECTIVETo investigate the impact of intravenous nutrition on plasma free amino acid spectrum and immune function for patients with sepsis.

METHODSForty severe sepsis patients were divided into two groups: Group B (amino acids + glucose + fat emulsion) and Group A (glucose + fat emulsion), 20 healthy individuals were enrolled as control group. The concentration of free amino acid and immune globulin were determined after 3 days.

RESULTSIn Group A, the levels of valine, leucine, isoleucine, alanine, serine, glutamic acid, histidine, proline and glycine were decreased; while the levels of threonine, cysteine, the ratio of phenylalanine and tyrosine (Phe/Tyr) were higher than those in control group. Meanwhile, peripheral blood IgM, complement C3 and C4 were decreased. In group B, all amino acid levels were improved, but the level of alanine, serine, glutamic acid, histidine and proline still lower than those in control group. Similarly, the levels of IgM, complement C3 and C4 in group B were increased.

CONCLUSIONIntravenous nutrition can support the basal requirement of amino acid and improve the immune function of patients with sepsis.

Adult ; Aged ; Amino Acids ; blood ; Complement C3 ; metabolism ; Complement C4 ; metabolism ; Female ; Humans ; Immunoglobulin M ; blood ; Male ; Middle Aged ; Parenteral Nutrition, Total ; Sepsis ; blood ; immunology ; therapy ; Time Factors

Objective To investigate the infections caused by Staphylococcus aureus carrying Panton-Valentine leukocidin(PVL)genes.Methods 26 isolates of Staphylococcus aureus carrying Panton- Valentine leukocidin(PVL)genes were determined by multiplex PCR.Multilocus sequence typing(MLST) was used to determine the STs of the isolates.The genotypes of SCCmec were also determined by another multiplex PCR in the isolates of methicillin-resistant Staphylococcus aureus(MRSA).Results Among 26 isolates,there were 6 isolates of ST88 MRSA,7 isolates of ST88 methicillin-susceptible Staphylococcus aureus (MSSA),5 isolates of ST239 MRSA,5 isolates of ST398 MRSA,1 isolate of ST25 MRSA,1 isolate of ST30 MRSA and 1 isolate of ST59 MRSA.20 isolates were hospital-acquired(HA)which mainly caused pulmonary infection and post-operative pyogenic infection.6 isolates were community-acquired(CA)which mainly caused soft tissue necrosis.Among 19 isolates of MRSA,ST88-SCCmec Ⅲ A,ST239-SCCmec Ⅲ,ST398- SCCmec Ⅳ and ST398-SCCmec Ⅲ were main types.26 isolates were isolated from 14 wards.ST88-SCCmec Ⅲ A-MRSA caused clone spread in maternity department in our hospital.Conclusion ST88,ST239 and ST 398 are main STs in Staphylococcus aureus carrying PVL in our hospital.The isolates not only cause nosocomial infections but also cause community infection.

OBJECTIVETo investigate the effects of raw rhubarb (RR) on levels of plasma D-lactate and procalcitonin in patients with sepsis.

METHODSForty patients with sepsis enrolled were randomly divided into two groups, the RR group (n=18, treated with RR 9 g/d) and the control group (n=22, treated with conventional treatment). Plasma procalcitonin and D-lactate were determined before and after treatment.

RESULTSBefore treatment, there was no significant difference in the levels of plasma procalcitonin and D-lactate between the two groups (procalcitonin: 6.50 +/- 2.37 microg/L vs 6.98 +/- 2.89 microg/L; D-lactate: 0.18 +/- 0.05 mmol/L vs 0.19 +/- 0.06 mmol/L, P > 0.05). However, after treatment, two indexes in the RR group were significantly lower than those in the control group (procalcitonin: 4.11 +/- 1.40 microg/L vs 2.21 +/- 0.61 microg/L; D-lactate: 0.24 +/- 0.06 ng/L vs 0.09 +/- 0.03 ng/L, both P < 0.05).

CONCLUSIONRR could ameliorate the intestinal permeability and reduce the shifting of intestinal bacteria, so as to ease the condition of disease in patients with sepsis.

Aged ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Lactic Acid ; blood ; Male ; Middle Aged ; Phytotherapy ; Protein Precursors ; blood ; Rheum ; Sepsis ; blood ; drug therapy

Objective To investigate the genetic polymorphism of mec Ⅰ in the clinical isolates of methicillin-resistant Staphylococcus anreus(MRSA).Methods 40 isolates(MRSA)carrying mecA gene were selected randomly from the clinical isolates of Staphylococcus anreus from Jan,2005 to Aug,2006 in our hospital.The mec Ⅰ gene was detected by PCR followed with sequencing.Staphylococcal cassette chromosome mec(SCCmec)in MRSA were detected by multiplex-PCR.Agar dilution method was used for determining the MICs of oxacillin against MRSA.Results 35 of 40(87.5%)MRSA carried mec Ⅰ gene.All isolates carrying mec Ⅰ gene have mecI 202C→T substitution,which resulted in Gln at 68 aminophenol position replaced by stop condon.32 isolates carried single point mutation.3 isolates carried double-point mutation,including additonal A at 3 positon,A→C at 41 position and C→T at 142 position beside C→T at 202 position,respectively.Among 35 isolates carrying mec Ⅰ gene,there were 27 isolates of SCCmec Ⅲ, 7 isolates of SCCmec Ⅲ A and 1 isolate of SCCmec Ⅱ.Among 5 isolates with deletion of mec Ⅰ gene,there were 3 isolates of SCCmecⅣ,1 isolate of SCCmec Ⅰ and 1 isolate of non-known SCCmec tpye.The MICs of oxacillin were 256-512 ?g/ml,≥512 ?g/ml and 8-256 ?g/ml in 31 isolates with single point mutation at 202 position in mec Ⅰ gene,3 isolates with double-point mutation in mecI gene and 5 isolates with deletion of mec Ⅰ gene,respectively.1 isolate with single point mutation in mec Ⅰ gene had contrary result(MIC