Extracorporeal Membrane Oxygenation ; Female ; Heart Failure ; therapy ; Humans ; Infant ; Postoperative Period ; Respiratory Insufficiency ; therapy ; Twins, Conjoined

Objective To study the therapeutic and protective effect of low tidal volume(LTV) ventilation in children with acute respiratory failure.Methods Forty-eight patients with respiratory failure were enrolled in our study.The patients were suffered from severe infection,trauma or after major operation.Besides general treatments,they were all given ventilation with LTV.Blood gas,ventilation parameters and complications related to ventilation were also measured.Results No significant difference was found between the patients with high tidal volume(HTV) and those with LTV in the results of improving respiratory acidosis.But the incidence of(ventilated-)induced lung injury(VILI) was lower in LTV patients.Conclusion LTV ventilation is preferable for children with acute respiratory failure and beneficial for alleviation of VILI.

Child ; Evidence-Based Medicine ; Guidelines as Topic ; Humans ; Nephrotic Syndrome ; diagnosis ; therapy ; Steroids ; therapeutic use

Chorionic Gonadotropin, beta Subunit, Human ; blood ; Down Syndrome ; blood ; diagnosis ; Female ; Humans ; Pregnancy ; Pregnancy, Twin ; Prenatal Diagnosis ; alpha-Fetoproteins ; metabolism

Objective To investigate the efficacy of monotherapy or combination of ACEI and ARB in treating diabetic nephropathy(DN). Methods 183 patients with DN were randomly allocated into three treatment groups: benazepril,losartan or the combination of these two drugs for 12 weeks.The changes of blood pressure, proteinuria, serum potassium and creatinine, creatinine clearance(Ccr)were observed before and after treatment. Results Both of benazepril and losartan reduced blood pressure and proteinuria efficiently.And their effects were similar.In contrast, the reduction in proteinuria was greater in the combination therapy than in treatments of either drug alone(P<0.05), but their reductions in blood pressure were achieved to the same level(P>0.05).There were not significant differences in serum levels of potassium, creatinine and Ccr before and after treatment(P>0.05). Conclusion A combination of ACEI and ARB in patients with DN produces a better anti-proteinuric effect than either of the monotherapies.This protection is not dependent on changes in blood pressure.

Objective To explore value of quantitative tissue velocity imaging(QTVI) in the regional systolic and diastolic myocardial function of hypertrophic cardiomyopathy(HCM) patients and healthy persons. Methods By Doppler myocardial imaging 20 HCM patients and 18 healthy subjects were collected,then the regional velocity were measured in the mid and basal segment in systolic,early diastolic and later diastolic period respectively. Results The parameters as systolic velocity(Vs),early diastolic velocity(Ve) and early systolic velocity/later diastolic velocity (Ve/Va) of the HCM group were significantly lower than those of the normal group,while later diastolic velocity(Va) showed no statistic difference between two groups. Conclusions The systolic and diastolic myocardial functions of hypertrophic cardiomyopathy patients are reduced. The abnormality of heart function in HCM patients could be accurately detected by QTVI.

Introduction of clinical cases to experiment teaching of pharmacology is an effective method,which combines basic theory with clinical medicine.It can stimulate students' interest in pharmacology,enhance their go-aheadism in study and also improve teaching effects.Moreover,it plays an important role in improving the students qualities such as the reasoning ability,the verbal capacity and the ability to analve and resolve problems,etc..In this article,we explored the teaching method in experiment teaching of pharmacology,and evaluated the effect by questionnaire.

Objective To investigate the surgical indications and repair methods for the treatment of electrical bums in the limbs.Methods Thirty-eight cases since May,1997 to June,2014 who underwent flap treatment in 7-14 days after electrical bums was summarized.Among these patients,4 cases were treated by local flaps,1 case was treated by thenar flap,2 cases were treated by dorsal island skin flap of the index finger,1 case was treated by cross-leg flap,1 case was treated by medial plantar skin flap;2 cases were treated by pedicle latissimus dorsi flaps,4 cases were treated by antebrachial flap with a pedicle of the posterior interosseous artery,4 cases were treated by metacarpal artery reversed island flaps,10 cases were treated by groin flaps;1 case was treated by free radial artery flap,1 case was treated by free latissimus dorsi flap,3 cases were treated by free anterolateral thigh flaps;1 case was treated by reverse island forearm posterior interosseous flap,2 cases were treated by posterior perforator reversed island flaps of the lower leg,1 case was treated by anterolateral perforator reversed island flaps of the lower leg.The area of flap was from 42.0 cm × 13.0 cm to 6.0 cm × 3.0 cm.The survival rate of the flap,the appearance and function of limb were observed.Results All these patients were followed up from 4 months to 3 years 6 months,the mean time was 6 months and 20 days.Thirty-five flaps survived completely,accounting for 92.1％,and 3 cases suffered partial necrosis at the distal end,accounting for 7.9％.Secondary healing was achieved by dress changing.The appearance of the limbs was satisfactory.Among the 28 cases whose bums were on the hands,the total number of excellent and good was 15,medium was 8,and 5 poor cases.The excellent and good rate was 57.1％.Conclusion Early repairing of the electrical burns with flaps is the effective method for protecting the deep structures of the limb,preventing and control the secondary infections and preserve the function of the limbs.

Objective To evaluate the regional myocardial systolic function in the patients with hypertrophic cardiomyopathy(HCM) by strain imaging technique.Methods Doppler myocardial imaging of 20 HCM patients(HCM group) and 22 healthy subjects(control group) was collected,and their regional peak systolic strain in the mid and basal segment was measured respectively.The data were compared and analyzed between the two groups.Results In the healthy subjects,the strain value showed no difference between regional myocardium.In the interventricular septum,anterior and inferior wall of left ventricle,the strain value of HCM group was significantly lower than that of control group.Conclusions Strain imaging could detect the abnormal regional myocardial function of HCM patients accurately, and provide a new quantitative parameter for evaluating the regional myocardial functions.

Objective To evaluate the effects on trabeculectomy combined with implantation of anterior lens capsule.Design Radomized,controlled experimental study.Participants 36 experimental albino rabbits.Methods 36 albino rabbits were divided into 3 groups randomly.The rabbit and human anterior lens capsules were implanted under the scleral flap in trabeculectomy in group A and group B respectively,while only trabeculectomy in control group.The average follow-up period was 12 months.Main Outcome Mea- sures Intraocular pressures(IOP),filtering bleb,complications.Results The postoperative IOP of the experimental groups decreased sig- nificantly as compared with preoperative IOP at 12 week postoperatively.Retention of reflective filtering bleb in experimental groups was longer than that in contral group(5.12?0.43week,5.05?0.59week,2.74?0.32week,P＜0.05).The passage of humor outflow kept open in ex- perimental groups and became closed in control group at 12 week postoperatively.Anterior lens capsule wasn't attacked by T or B lym- phocyte seen with electron microscope.Conclusions Implantation of anterior lens capsule may help to postpone filtering bleb scarring in the trabeculectomy.This study provides experimental basis for the clinical practice.