Drugs, Chinese Herbal ; therapeutic use ; Glomerulosclerosis, Focal Segmental ; drug therapy ; Humans ; Sclerosis

Objective To evaluate the changes of pulmonary gas exchange and intrapulmonary shunt during orthotopic liver transplantation (OLT) Methods Eleven ASA Ⅲ Ⅳ patients (male 8, female 3) with end stage liver diseases were studied Age ranged from 17 67 yr Anesthesia was induced with midazolam 0 1 mg?kg -1 , fentanyl 5?g?kg -1 and pipecuronium 0 1 mg?kg -1 and maintained with isoflurane inhalation and intermittent iv boluses of fentanyl and pipecuronium combined with epidural anesthesia (T 8 9 ) The patients were mechanically ventilated with 100% O 2 during operation After induction of anesthesia Swan Ganz catheter was inserted via right internal jugular or subclavian vein Cardiac output (CO),mixed venous oxygen saturation and core venous temperature were continuously monitored with continuous cardiac output monitor (Baxter,Vigilance) ECG, CVP, SpO 2 and P ET CO 2 were also continuously monitored during operation Radial artery was cannulated for continuous direct blood pressure monitoring Arterial and mixed venous blood samples were taken at the beginning of operation, 120 min during preanhepatic stage, 30 and 60 min during anhepatic stage, 5 and 60 min during neohepatic stage and at the end of operation Alveolar arterial oxygen partial pressure difference (A aDO 2) , intrapulmonary shunt (Qs/Qt) , oxygen delivery index (DO 2I) and oxygen consumption (VO 2 I ) were calculated During operation body temperature was maintained above 35 5℃ Veno venous bypass (VVB) was performed during anhepatic stage Results At the beginning of operation, when FiO 2 was 100%, PaO 2 was only (376?141) mmHg, A aDO 2 and Qs/Qt were all higher than normal values There were no significant changes in all parameters 120 min during preanhepatic stage as compared with those at the beginning of operation PaO 2 increased and A aDO 2 and VO 2I decreased significantly during anhepatic stage Qs/Qt, A aDO 2 and PaCO 2 increased and PaO 2 decreased significantly, but there were no significant changes in cardiac index, DO 2I and VO 2I during early neohepatic stage Cardiac index, DO 2I and VO 2I increased at 60 min during neohepatic stage and at the end of operation Conclusions There are severe changes of pulmonary gas exchange during OLT

Objective To assess the effect of propofol on changes in plasma enzymes (CPK,LDH), lipid peroxides (MDA) and metabolites of arachidonic acid (TXB 2,6 keto PGF 1? ) after ischemia reperfusion of lower extremity.Methods 19 ASAⅠ Ⅱscheduled for bilateral total knee replacement were randomly allocated to one of the two groups: isoflurane group (group I,n=10) and propoful group(group P, n=9). The patients were premedicated with intramuscular pethidine 50mg and scopolamine 0.3mg 30min before operation. In isoflurane group anesthesia was induced with midazolam 0.15mg?kg -1 ,fentanyl 3?g?kg -1 and vecuronim 0.1mg?kg -1 and maintained with 0.8% isoflurane after tracheal intubation. In propofol group anesthesia was induced with propofol 2mg?kg -1 ,fentanyl 3?g?kg -1 and vecuronim 0.1mg?kg -1 and maintained with propofol infusion 8mg?kg -1 ?h -1 . In both groups general anesthesia was supplemented with epidural block performed at L 2 3 . Blood samples were taken from femoral vein before the tourniquet of right leg was inflated(0min) and 5,10,20min after replace of left leg for determination of plasma creatine phosphokinase(CPK),lactate dehydrogenase(LDH),MDA,TXB 2 and 6 keto PGF 1? levels.Results In group P CPK and LDH levels decreased significantly at 10,20min and MDA level at 5min(P

Objective:To isolate mesenchymal stem cells (MSCs) from mouse fetal liver and induce them differentiate into islet B-like cells. Methods:MSCs were isolated from C57BL/6J mouse fetal liver and were induced with high concentration of glucose, basic fibroblast growth factor(bFGF) ,and nicotamine medium. The gene expressions related to islet B cells such as pancreatic duodenal homeobox-1 (PDX-1), proinsulin-1 (INS-1) ,and glucose transporter-2 (GLUT-2) were detected by RT-PCR. Insulin in the treated cells was examined by immunocytochemistry. The insulin clusters were stained with dithizone (DTZ), a zinc-chelating agent known to selectively stain pancreatic B cells. Results: RT-PCR showed that the treated cells expressed PDX-1, INS-1 and GLUT-2, while the undifferentiated cells did not. After approximately 10 d of treatment, the fetal liver cells formed DTZ-stained cell clusters in flasks (80-120 clusters in a flask 25 cm2 in area). Immunocytochemistry also confirmed that these aggregates were strongly positive for insulin. Conclusion: MSCs derived from fetal liver can be induced into islet B-like cells in vitro.

The precise measurement in lens thickness in vivo, provides great application value for intraocular accommodation and ametropia development mechanism research.And it has great clinical significance for the diagnosis and treatment of glaucoma and cataract.Currently, many ultrasonic methods and optical methods are used in measuring lens thickness.The measurement principles, advantages, disadvantages and the accuracy of the instruments are summarized in this paper.Among these methods, Orbscan II, Pentacam, Lenstar and AS-OCT can be used to measure lens thickness instead of A-scan.More important is the fact that UL-OCT can dynamically monitor the change of the lens thickness with intraocular accommodation.Choosing an instrument with higher measuring accuracy to examine the lens thickness, can provide more accurate and convincing lens thickness data for clinical and scientific research.

The examinations of blood and bone marrow in 125 patients with visceral leishmaniasis revealed that seven routine parameters of the blood samples were below the lower limit of normal in most cases and 64.8% of the cases showed complications with iron deficiency anemia(IDA) and cell maturation disorders.Therefore, iron deficiency anemia and significant reduction of blood components can be used as indicators on the severity of Leishmania infection.

OBJECTIVE To investigate the incidence of integrons in Pseudomonas aeruginosa strains isolated from blood samples in Peking University People′s Hospital and to analyze the correlation between integrons and drug resistance of P.aeruginosa.METHODS Forty-two strains of clinically isolated P.aeruginosa were collected.The antibiotics susceptibility was tested by K-B methods.Integrase gene of integron was amplified by PCR using degenerate primers.The integrons were classified by restriction fragment length polymorphism(RFLP) analysis of positive PCR products with Hinf Ⅰ restriction enzyme.RESULTS The drug-resistance rates of 42 strains of P.aeruginosa against 20 kinds of antibiotics ranged from 9.5% to 100%.Twenty-three strains were resistant to 12 kinds of antibiotics.Nineteen of the 42 isolates(45.2%) contained integrons,all of which were revealed as class Ⅰ of integrons by RFLP analysis.Neither class Ⅱ nor class Ⅲ of integron was detected.The positive percentage of integrons was increased by years.CONCLUSIONS Class Ⅰ integrons are widespread in isolates from blood samples in our hospital.The presence of integrons is closely associated with multi-drug resistance of P.aeruginosa.

OBJECTIVE To intensify the management of the acupuncture department and prevent and control nosocomial infection.METHODS During the course of the management of the acupuncture department,the causes of nosocomial infection were found through analyzing the possible reasons of nosocomial infection and a series of relevant measures were taken to improve the control of nosocomial infection.RESULTS In order to control nosocomial infection in acupuncture department we needed to strength the disinfection management in the following aspects:air in the room,medical procedures and implement,medical staff hands and medical disposals.CONCLUSIONS Strict management is the important measures to reduce the nosocomial infection.

Abscess ; complications ; Adult ; Brain Abscess ; complications ; Female ; Humans ; Meningocele ; complications ; Nasal Cavity ; pathology ; Nose Diseases ; complications

Objective To investigate the clinical characteristics, diagnosis and treatment of placenta increta.Methods A retrospective analysis was carried out on 13 admitted cases of placenta increta from 1989～2006. Results Among the 13 cases analysed, 5 cases with a history of Caesarian section had a 0% success rate of treatment with conservative care (0/5), 100% less than that of cases with no history of Caesarian section (8/8), P＜0.05; the success rate of treatment of partial placenta increta with methotrexate with Jia Wei Sheng Hua Tang was 100%. Conclusion Caesarian section is a risk factor of placenta increta, and its prognosis is poor; however, Jia Wei Sheng Hua Tang has proven satisfactory as a supplementary treatment for placenta inereta.