We observed 38 patients' breath frequency after different oxygen therapy according to their visit sequences and tolerance conditions.All patients with chronic obstructive pulmonary.disease (COPD) plus carbon dioxide retention from April 2008 to June 2011 were recruited at our hospital.Twentythree patients who could maintain SpO2≥92％ through inspiring O2 at ≤3.5 L/min were assigned into the first group.And another 15 subjects whose SpO2 could not reach 92％ at the same oxygen flow for 5 hours were assigned into the second group.The second group received an elevated oxygen flow until their SpO2 attained 92％ or so.But the maximal rate did not exceed 8 L/min even if SpO2 was below 92％.The state was maintained for 5 hours.Paired t-test showed PaO2 became elevated and PaCO2 decreased significantly on onset and termination of low oxygen flow in both groups.But the frequency of the second group's breaths per minute (BPM) had no significant differences.After elevating oxygen flow,the second group's BPM and PaCO2 on onset and termination were (19.4 ± 3.4) and (18.1 ± 2.6) perminute (P =0.038),(55.0 ±8.1) and (52.0 ±7.9) mm Hg (1 mm Hg =0.133 kPa) (P =0.030) respectively and the results showed significant decreases.But SpO2 was elevated [(85.8 ± 4.1) and (90.7 ± 2.4) mm Hg (P =0.000)].

Objective To investigate the injury effects and mechanisms of circulating histones on the hepatocytes in patients with hepatitis B virus (HBV )-related liver failure (HBV-LF) .Methods Serum samples from patients with HBV-LF were collected . The levels of serum histone H3 , histone H4 , prothrombin activity (PTA ) ,total bilirubin (TBil) ,creatinine (Cr) and international normalized ratio (INR) of the patients were measured .Model for end-stage liver disease (MELD) score was calculated in the patients .The serum levels of histones were compared between patients and the healthy volunteers . The correlation of histones with the MELD score and PTA was analyzed .The human liver cell line L-02 cells were cultured and treated with the serum of patients or L-02 cellular lysate supernatant preincubated with or without anti-histone H3 and H4 antibodies .The cellular morphology and rate of apoptosis were observed .Intracellular calcium ion concentration and Caspase-3 activity were detected in the cultured L-02 cells treated with histones .Mean of two independent samples was compared using t tests .Relationship between histones and the MELD score or PTA was conducted using Spearman correlation analysis .Results The levels of serum histones in the patients with HBV-LF were much higher than those in the healthy volunteers (H3 :[5 390 .3 ± 1 032 .0] μg/mL vs [42 .7 ± 12 .8] μg/mL , t = 32 .76 , P < 0 .01 ; H4 :[4 205 .1 ± 662 .3] μg/mL vs [40 .3 ± 14 .6] μg/mL ,t = 39 .74 , P< 0 .01) .In addition ,serum histones (H3/H4) levels in patients were negatively correlated with serum PTA (r= - 0 .325 ,P= 0 .038 and r =- 0 .572 ,P= 0 .028 ,respectively) ,but positively correlated with the MELD score (r= 0 .359 ,P= 0 .021 and r = 0 .568 , P = 0 .007 , respectively ) . Both serum of patients with HBV-LF and L-02 lysate supernatant were toxic to cultured L-02 cells .The injury effect was inhibited by anti-histone antibodies ([9 .3 ± 1 .5]% vs [14 .3 ± 0 .6]% , t = 4 .259 , P= 0 .02) .L-02 cells treated with calf thymus histone were cultured for 4 h . Cellular toxicity of histones resulted in Caspase-3 activation . The effect was inhibited by anti-histone antibodies ([3 .5 ± 0 .5]% vs [5 .2 ± 0 .6]% ,t= 4 .243 ,P= 0 .02) .Conclusion The elevated circulating histones in the patients with HBV-LF may aggravate the liver damage .

Female ; Humans ; Hyperkeratosis, Epidermolytic ; pathology ; Infant, Newborn

Objective: Enhanced expression of adhesion molecules on synovial tissu e has been demonstrated in patients with dialysis-related amyloidosis (DRA). T he study was conducted to elucidate the mechanisms by which the expression of adh esion molecules on synovial cells was up-regulated.Methods: Human type-B synov ial cells were cultured in vitro with β2-microglobulin modified with adva nced glycation end products (AGE-β2m) , native β2-microglobulin (β2 m) , tumor necrosis factor-α（TNF-α）and interleukin -1β（ IL-1β）. The expression of intercellular adhesion molecule-1(ICAM-1), vasc ular cell adhesion molecule-1(VCAM-1), and E-selectin was examined by immunofluor esc enct staining and flow cytometer analysis. Results:ICAM-1 and VCAM-1, but not E -selectin, were constitutively expressed on human type-B synovial cells. TNF -α a nd IL-1β enhanced the expression of ICAM-1 and VCAM-1 in a dose- and time - depen dent manner. Neither of these cytokines appeared to induce the expression of E - selectin. Both β2m and AGE-β2m had no direct effect on the expression of the a dhesion molecules.Conclusion: Elevated level of IL-1β and TNF-α in the synov ial tissue may up-regulate the expression of adhesion molecules on synovial cel ls and therefore promote local monocytes infiltration.

0.05),indicating that two groups had the similar effect on relieving pain.VAS score in both groups was markedly decreased after treatment(P0.05).Conclusion Acupuncture is effective in the treatment of lumbodorsal myofascial pain syndrome,and its effect is similar to that of local block of trigger points with lidocaine.Acupuncture has less side effect.

In the clinical skill evaluation,SP and the new technology OSCE for medical educational evaluation brought by SP can offer a vivid and complete exam atmosphere for the medical students,which have been widely applied by medical colleges and schools at home and abroad,with real,effective,reliable characteristics and broader development prospect. To induce the technology into TCM clinical evaluation is in accordance with the requirements of TCM educational development,which can make students better grasp clinical various basic skills within limited studying periods.

Objective The study was performed to determined the significance and safety of liver biopsies in these patients as a pre-transplantation screening test. Methods From January 1999 to August 2002, seventy-four renal transplant recipients with hepatitis B or C virus infection were received the percutaneous liver biopsy. The severity of liver inflammation(G) and fibrosis(S) were evaluated by semi-quantity technique. The patients whose liver histological diagnosis was G 0-2 S 0-2 received renal transplantation(n=31). Patients with hepatitis B or C virus infection who received renal transplantation in the period of January 1995 to December 1998 were selected as historic controls. Normal level of serum transaminase was considered as a indication for the received renal transplantation during this period. The incidence of liver dysfunction after transplantation was compared between the two groups. Results It showed among thirty-one patients received renal transplantation from 1999-2002, only 1 patient (3.2%) developed liver failure after transplantation. However, among 60 patients of historic control, 17 (23.8%) suffered from liver dysfunction (P

Dieulafoy lesion are usually located in the stomach but can also occur in the small or large intestines. It is an uncommon but significant source of massive upper gastrointestinal hemorrhage. A female patient with Dieulafoy lesion was admitted to the Tenth People's Hospital of Tongji University on June 2, 2009. The site of the lesion was diagnosed at the anterior wall of stomach with a bleeding vessel in the center. The size of the lesion was about 1.0 cm×1.0 cm. Partial gastric resection was successfully performed using laparoscopy and endoscopy. The lesion was demarcated by gastroscope, and then it was hung up and removed by laparoseope. Bowel movement recovered at the second day, and the patient was discharged 6 days after surgery. The patient was followed up for 1 month, and no recurrent hemorrhage or other complications were observed. The combined approach of laparoscopy and endoscopy not only resects the lesion completely and widens the scope of minimally invasive surgery but also decreases the risk of operation.

Objective To investigate a method that perfect imaging could be obtained and minimal contrast media was used. Methods The 5 cases with enhanced CT images were measured at each slice, then the Hu of aim-position was obtained and the Hu-time curve was got. At last, the valid enhanced period would be found. Results According to the experience, the enhancement threshold of aorta, portal vein and hepar were set at 70 HU. The onset and ending time of enhancement threshold were found. Conclusion The dose of contrast media should be extenuatory when new type spiral CT was operated, and the correlative parameters, such as flow rate, delay time etc. should be adjusted according to the objective condition.

Objective To investigate the change in potassium channel in ventricular myocytes in vitro derived from diabetic rats and the effect of insulin and dichloroaectic acid(DCA). Methods The diabetic rat model was established by injection of streptozocin(STZ) peritoneally using male Sprague-Dawley rats with body weight 150-200 gram. Ventricular myocytes were isolated by enzymatic method and the whole-cell patch clamp technique was used to record the potassiumion currents. Results The I to density of ventricular myocytes in diabetic rats was significantly decreased compared with control rats[at+60 mV, 15.90?1.19 pA/pF (n=25) vs 28.55?0.97 pA/pF (n=12), P