Objective To investigate complications in patients after noncardiac thoracotomy in hypothyroidism with ST changes. Methods Sixty one patients with hypothyroidism undergoing noncardiac thoracotomy were divided into ST segment change group(28 patients having ST segment depression≥0.05 mV) and controls(33 patients) according to the results of Holter. All patients were added with thyroid hormone, until the function of thyroid gland was normal before thoracotomy. The myocardial ischemia was measured by Holter within 48 hours after thoracotomy. Serum thyroid hormones was examined by radioimmunoassay during, before and after thoracotomy. And cardiovascular events were foliowed-up to hospital. Results Before and after thoracotomy serum TT3 in ST segment change group was (1.30±0.41), (2.09±0.45)nmol/L, TT4 was (80.56±30.28), (84.55±33.57) nmol/L, respectively; compared with the control group[TT3: (1.43±0.52), (2.38±0.51)nmol/L, TT4:(82.70± 29.43), (93.47±35.02)nmol/L], no significant differences were found(all P>0.05). After thoracotomy, 24 patients occurred myocardial ischemia, 10 patients occurred cardiovascular events in ST segment change group; 8 patients occurred myocardial ischemia, a patient occurred cardiovascular events in control group, there were significant differences between two groups(χ2=22.95,10.95, all P<0.05). The positive predictive value of ST segment change in Holter detection was 36% (10/28) recording in cardiovascular events of patients with cardiovascular disease undergoing noncardiac thoracotomy and hypothyroidism, negative predictive value was 97%(32/33). Conclusions Myocardial ischemia and other cardiovascular events tend to occur in hypothyroidism patients with ST segment change after noncardiac thoracotomy. ST segment change of preoperative Hoher detection recording cardiovascular events of hypothyroidism patients undergoing noncardiac thoracotomy has certain predictive value.

Objective To study the prognostic value of initial arterial lactate level and to explore the relationship between early arterial lactate and the outcome of patients with acute paraquat poisoning by analyzing the clinical data of 235 cases.Methods A total of 235 patients with acute paraquat poisoning were admitted to the Emergency Intensive Care Unit (EICU) from January 2009 to June 2012.Demographics,clinical and laboratory findings were compared between the survivors and non-survivors.Receiver operating characteristic (ROC) curves were used to identify the optimal cut-off points for initial arterial lactate level.Results Totally 235 patients with average age of (33.6 ± 11.5) years old (ranging from 18 to 74),89 male and 146 female.The median estimated amount of 20％ paraquat ingested was 55 mL,(ranging from 10 to 280,IQR:27 mL,77 mL),the median length of time between paraquat ingestion and the arrival at the emergency department was 4.5 h (ranging from 0.5 to 10.5,IQR:2.3 h,6.8 h).The overall mortality rate was 74.0％ (174/235) during a 28 days follow-up period,only 61 of 235 patients survived.The initial arterial lactate level was higher in non-survivors than that in survivors (2.79 ± 0.76) mmol/L vs.(1.62 ± 0.48) mmol/L,P =0.028).Correlation analyses showed that the initial arterial lactate level was associated with increased risk of 28-day mortality (r =0.26,P =0.004),and as the initial lactate increased,the survival time of non-survivors shortened (F =3.246,P =0.037).Using the ROC curve analysis,the initial arterial lactate level had an area of 0.799 (95％ CI:0.745-0.866) and the cut-off point of concentration was 2.57 mmol/L for prediction of prognosis in patients with acute paraquat poisoning (sensitivity 85.2％,specificity 79.6％,the best Youden index was 0.648).The initial arterial lactate level was higher in patients died from circulatory failure rather than from respiratory failure (5.22 ± 1.46) mmol/L vs.(1.87 ± 0.62) mmol/L,P =0.042.And the survival time of patients died from circulatory failure was shorter than that from respiratory failure (4.1 ± 1.3) d vs.(11.6 ± 3.2)d,P =0.023.With the ROC curve analysis,the initial arterial lactate level had an area of 0.882 (95％ CI:0.805-0.941) and the cut-off point of concentration was 3.65 mmol/L for prediction of prognosis of patients died from circulatory failure (sensitivity 87.6％,specificity 82.5％,the best Youden index was 0.701).Conclusions The initial arterial lactate level may be one of early indicators of prognosis in patients with acute paraquat poisoning and it had high potential in predicting the outcome of patients died from circulatory failure.

Objective To investigate the clinical factors dominant in the efficacy of lung recruitment maneuver (RM) with high-level positive end-expiratory pressure (PEEP) under pressure control ventilation in patients with 2009 influenza A (H1N1)-associated acute respiratory distress syndrome (ARDS) by analyzing the clinical data of 24 patients treated with mechanical ventilation.Methods A retrospective study was carried out in a 16-bed capacity emergency intensive care unit (EICU) of the First Affiliated Hospital of China Medical University from October 2009 to January 2010.Twenty-four patients with influenza-associated ARDS were included.During pressure control ventilation,when SpO2 persisted lower than 88％ for more than 30 min,RM with high-level PEEP was initiated to normalize lung volume at 30 cmH2O for 60 s.The RM was responded as SpO2 increased more than 3％ within 15 min; otherwise,the increase below 3％ in SpO2 would be considered non-responded.Variations in respiratory mechanics,oxygen metabolism and hemodynamic parameters were measured before and after RM.Results Of 24 patients with influenza-associated ARDS,16 survived and 8 deceased.The median duration of mechanical ventilation (DMV) in EICU was 5.5 days (range from 3.5 to 12.0 days).During the entire study period,a total of 158 RMs with high-level PEEP were done,including 76 (48.1％) responded RMs (the responded group) and 82 (51.9％) non-responded RMs (the non-responded group).In survivor group,the ratio of effective RM was higher than in nonsurvivors group (66.2％ vs.33.3％,P ＜ 0.01).Compared with the data before RM,HR was increased (92.6 ± 11.8) vs.(73.0 ± 12.6),P =0.038 and MAP was decreased (66.1 ±9.3) mmHg vs.(73.9 ± 11.4) mmHg,P=0.049 during RM,and these difference were not statistically significant at 3 min after RM.The decrease in SpO2 after 134 procedures of RMs in 85.9％ patients,and the minimum value of SpO2 occurred at (2.1 ±0.6) min after RM.In the responded group,the maximum SpO2 were higher than that before RM by (6.9 ± 1.6) ％ occurred at (12.7 ±2.6) min after RM.Compared with the data before RM,SpO2 were increased (90.4 ± 4.4) ％ vs.(86.7 ± 7.6) ％,P =0.047) in responded group at 30 min after RM.The initial PEEP level in the responded group was lower than that of the non-responded group (8.6 ± 3.4) cmH2O vs.(11.3 ±4.2) cmH2O,P=0.028.The initial mean DMV in the responded group was also shorter than that in the non-responded group (4.1 ± 3.1) d vs.(5.8 ± 2.5) d,P =0.011.Furthermore,the initial dynamic lung-thorax compliance (Cdyn) was obviously higher in the responded group than that in the non-responded group (30.8 ±6.2) mL/cmH2O vs.(26.1 ±5.1) mL/cmH2O,P=0.038.Conclusion The lung RM with high-level PEEP may cause temporary hemodynamic changes and the initial PEEP level,DMV,and Cdyn may be potential factors influencing the efficacy of lung RM.

Objective To investigate HIV infection via sex in Xinjiang,in order to provide guidance for the formulation of strategy to control and prevent sexual transmission of HIV.Methods Vistiors to 15 STD clinics in 5 cities of Xinjiang were asked to take blood and to be tested for HIV and RPR.At the same time,medical workers carried out the designed investigation.Result A total of 2 499 STD outpatients were investigated,among whom 28 samples were confirmed to be HIV positive and 145 samples were RPR positive;the infection rate was 1.12% and 5.80%,respectively,with male being 0.97% and female being 1.37% in the positive samples.The Han nationality had 8 HIV positive samples,and the Uygur nationality had 20 positive samples,with the positive rate being 0.44% and 3.49%,respectively.The Han nationality had 66 and the uygur had 79 in RPR positive samples,the positive rate being 3.66% and 13.79%,respectively.In 212 cases of syphilis 4 samples were HIV positive,the infection rate being 1.89%;in 420 cases of GU 10 samples were HIV positive,the infection rate being 2.38%.Our behavioral surveys found that those who 100% used condoms in their sex activities were free of HIV infection,while those who never used condoms had a high ratee of infection,up to 2.77%.Conclusion Sex transmission is becoming an important route of spreading HIV infection in Xinjiang,and therefore it is essential to strengthen serological and behavioral surveillance for high risk population and implement effective interventions for them.

Humans ; Periodontal Diseases ; therapy ; Tissue Engineering

Melanin is formed by oxidative polymerization of phenolic compounds,basically different kinds of melanin come from different organisms.DOPA melanin and DHN melanin have same physical and chemical characters although they have different biosynthetic pathway.DHN melanin is common in plant fungi and plays an important role on infection.The melanin accumulates in the fungal cell walls and prevents organic and inorganic molecules penetrating out,that insures appressorium's pressure and infection ability.This paper has reviewed the kinds and characters,especially discussed the role of melanin during pathogen infection based on our some research.

Objective To study antibacterial effect of formulas, borneol, honey, gentamicin in wet honey ice bedsores.Methods The third-stage infective bedsore model in rabbit were estabished with Staphylococcus aureus ( S.aureus) , Escherichia coli ( E.coli) , and Pseudomonas aeruginosa ( P. aeruginosa).The rabbits with bedsore were respectively compressed with gauze of honey+borneol, honey+gentamicin,borneol+gentamicin,borneol+gentamicin+honey, vaseline as control group.The strain identification and colony counts were observed before and after treatment.ResuIts The colony count of S.aureus, E.coli and P.aeruginosa in honey+borneol, honey+gentamicin, borneol+gentamicin, borneol+gentamicin+honey post-treatment was significantly higher than that of pre-treatment, respectively (P<0.05).The colony count of three strains in above four formulas post-treatment was significantly lower than that in vaseline group, respectively (P <0.05).The colony count of three strains in borneol +gentamicin +honey (original formula) post-treatment was significantly lower than that in the other formulas, respectively (P<0.05).ConcIusion The antibacterial effect of borneol+gentamicin+honey (original formula) is the best.

Objective To study the antibacterial effect of borneol, honey, gentamicin in Ruchuang Bingmi hydropathic compress agent.Method Staphylococcus aureus(S.aureus), Escherichia coli(E.coli), Pseudomonas aeruginosa(P.aeruginosa) were used to produce the third phase of infection decubitus animal models, respectively.Vaseline as the control group, divided into 12 groups:Vaseline-S.aureus, Vaseline-E.coli, Vaseline-P.aeruginosa;Honey-S.aureus,Honey-E.coli,Honey-P.aeruginosa;Borneol -S.aureus;Borneol -E.coli;Borneol-P.aeruginosa;Gentamicin-S.aureus;Gentamicin-E.coli;Gentamicin-P.aeruginosa;6 rabbits in each group.Honey, borneol, gentamicin was made into a gauze in treatment for decubitus .Organizations do strain identification and colony counts was observed before and after taking the treatment.ResuIts Borneol group ( F =11.059,P<0.01).,there was differences of each groups count cultured by borneol;Time ×Strains(F=11.281,P=0.009),there was no significant interaction between the two groups;gentamicin(F=7.99,P=0.000),gentamicin culture showed a difference in each group count;Time ×Strains(F=12.531, P<0.07),interaction between the two groups showed significant.Borneol has no antibacterial effects on P.aeruginosa , had a certain antibacterial activityon S.aureus and E coli;gentamicin had good antibacterial effect on the three kinds of bacteria, and against P.aeruginosa was particularly significant.ConcIusion The antibacterial activity of gentamicin is better than single herbs borneol in Ruchuang Bingmi hydropathic compress agent, honey has no antibacterial effect.

BACKGROUND: The extramedulary fixation system including dynamic hip screw (DHS) is commonly used in treatment of Intertrochanteric fracture. However, in patients with unstable intertrochanteric fracture, extramedulary fixation system often leads to the failure of fracture fixation. Intramedulary fixation system including both proximal femoral nail antirotation (PFNA) and InterTan nail has been widely used in the treatment of unstable intertrochanteric fractures. OBJECTIVE:To compare the therapeutic effects of extramedulary fixation system containing DHS, PFNA and InterTan nail in the treatment of intertrochanteric fracture. METHODS:Literatures were searched in Wanfang, PubMed, Embase, Medline, the Cochrane library to screen literatures published from January 1990 to November 2014. Relevant studies addressing extramedulary fixation system containing DHS, PFNA and InterTan nail were screened. RESULTS AND CONCLUSION: 346 articles were screened, and 13 of them were in accordance with the inclusion criteria. 1 271 patients with different types of intertrochanteric fracture were assessed in this study. Compared to DHS group, patients treated with PFNA and InterTan nail had shorter operation time and less blood loss. No significant difference in rehabilitation time and Harris score was detected among three kinds of fixation methods. Additionaly, PFNA and InterTan nail had a similar effect. These findings verify that compared with DHS, PFNA and InterTan nail can optimize the surgery, but cannot elevate postoperative outcomes.

Select patients diagnosed of hypertension in the first place in 16 hospitals and the patients were described by association rules analysis and distribution for the analysis in the study,in order to understand the information of diagnosis and treatment in hypertension patients in real world. The information include age, gender, admission condition, inpatient department, hospitalization expenses, western medicine comorbidities, the traditional Chinese medicine (TCM) syndrome and the medicine. The average age of patients was 64 years in the study. The proportion of men to women about 1. 10: 1. Admission condition is critical for about 10.12% of the total and more concentrated in the cardiovascular department. Hospital stay ranged from 8 to 14 d. Inpatients with medical insurance is 62.93%. Total hospitalization cost distribution most is the 5 000-10 000 RMB. Hypertension complicated with coronary heart disease, blood lipoprotein disorder disease; phlegm and blood stasis and Yin deficiency of liver and kidney are the most in TCM syndrome type. Promoting blood circulation and removing blood stasis is the major in Chinese medicine treatment. Western medicine treatment basically conforms to the guidelines. The most antihypertensive drugs is calcium antagonistst, accounting for about 81.2% of the total number. Class ACEI, class ARB, beta blockers, diuretics class are accounted for 43.0%, 43.4%, 42.4%, 42.4%, fixed compound is only 2 393, accounting for about 8%. the total frequency of five classes of antihypertensive drugs is 78 206 times. The principal conclusions of this analysis are as follows: the elderly people is the most in hypertension, more men than women; medical insurance is the majority type in hospitalization cost; nearly half of the population is combined with coronary heart disease; phlegm and blood stasis and yin deficiency of liver and kidney are the most in TCM syndrome type; western medicine treatment basically conforms to the guidelines. Combination therapy is more, less fixed compound preparation in western medicine. Chinese medicine is mainly to promoting blood circulation. Suggesting that the clinical treatment in strict blood pressure and at the same time, pay attention to combination therapy and the use of fixed compound preparation,it's useful to control the blood pressure better. Combined with traditional Chinese medicine and resolving phlegm and removing blood stasis, reduce the target organ damage, reduce complications, the prevention and control work of hypertension in China still faces enormous challenges at present. The result provides reference information for clinical medicine and medical research.
Adolescent ; Adult ; Aged ; Antihypertensive Agents ; therapeutic use ; Blood Pressure ; drug effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension ; complications ; drug therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Treatment Outcome ; Young Adult