Objective Our purpose was to report Initial clinical application experience and assess the immediate and short-term effect of transcatheter closure secundum atrial septal defects (ASD) using Amplatzer atrial septal ocluder.Methods Procedures were perfomed under fluoroscopy and transesophageal echocardiography monitoring. Nine patients (3 male, 6 female) underwent attempted transcatheter closure of a ASD using the Amplatzer atrial septal ocluder device with 10F, 11F or 12F long sheath at a mediant age of 33.0?5.2 years (range 8 to 52 years) and weighed 22 kg or more. Other congenital cardiac anomanies which require surgery were excluded. The mediant diameter of ASD at its narrowest segement were mensureted with the balloon catheters was 23.3?6.2 mm (ranger 11 to 30 mm). Systolic pressures of pulmonary arteries were 24.4?5.5 mm Hg (24-46 mm Hg) with catheterization mensuration. After the procedure, TEE were perfomed immediately to find whether there any residual shunt retained. Follow-up evaluation was color flow mapping at 24 h, 1, 3 and 6-months after closure. Results Nine patients had successful device placement. Transesophageal echocardiography showed that 8 patients had complete immediate closure and one had a small residual shunt after the operation, and could get up in the next day. The complication of cerebral throumbus embolism occurred in one woman patient during the procedure. She accepted immediately thrombolysis therapy with urokinase and recovered after several days. Conclusion Transcatheter closure of secondum ASD using Amplatzer atrial septal occluder device is an effctive nonsurgical therapy method. The operation has specialities of simple, safe with a high succes rate of placement and a fine occlusion effect. Further clinical trias are underway.

In the article we described a case of 61-year-old male with pharyngeal paraesthesia for 3 months. Physical examination: lean physique; vast uneven white membrane above hard palate, soft palate and pharynx mucous membrane, not easy to wipe and extend to the throat. The neck without cervical lymph node enlargement. Blood routine test: WBC 4.92 x 10(9)/L, N 64.3%, L 18.7%, EO 7.1%. RBC 4.08 x 10(12)/L, PLT 181 x 10(9)/L. No significant abnormal in the other blood biochemical indexes, tumor marker and immune indexes; blood bacteria culture: negative; blood culture: negative; sputum culture (3 times): all negative; anti-HIV screening test: positive, serum HIV testing: positive(the test done by Shanghai Pudong new area's centers for disease control and detection). The incidence of HIV/AIDS is still low at present, so the diagnosis of HIV/AIDS can be ignored easily by the otolaryngology doctor. If the patient with oral cavity and pharyngeal ulcer delayed healing, the doctor should be alert to,HIV/AIDS infection. We should check serum HIV antibody to eliminate or confirm HIV/AIDS earlier.
HIV Infections ; diagnosis ; Humans ; Male ; Middle Aged ; Otolaryngology ; methods

Described in this paper are the contents and objectives of embedded information service for research on aviation medicine in light of information access, identification and analysis in persons engaged in research on aviation medicine.

20?g/L) after surgery in one month.The survival rate for 1,3,5yr were 100%(n=17),91.5%(n=16) and 84.7% (n=14) respectively in the therapy group,and in the control group 95.45% (n=21),72.7% (n=16),40.91%(n=9) respectively.Sur- vival rate between two groups showed significant difference (P

Objective To explore the method and effect of checklist tool implemented in the safety management of clinical blood transfusion in intensive care unit. Methods A checklist was specially designed according to the technical standard and check system of clinical blood transfusion. 379 patients prescribed a blood transfusion enrolled in ICU from January to May 2013 were conducted as the control group before the checklist was designed. After the application of checklist during the blood transfusion process, 846 patients prescribed a blood transfusion enrolled in ICU from June to December 2013 were conducted as the experimental group. The incidence of blood transfusion safety related adverse events between the two groups was compared. Results The incidence of adverse events was 1.32% (5 of 379 patients) in the control group, and there was no sign of adverse events occurred in the experimental group. The difference had statistical significance (χ2=11.21, P<0.05). Conclusion The application of checklist reduced the incidence of blood transfusion safety related adverse events,and effectively improved the quality of nursing safety and patient satisfaction.

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on brain injury in the patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-five patients with chronic valvular heart disease,aged 36-62 yr,weighing 42-92 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with New York Heart Association of Ⅱ or Ⅲ,undergoing cardiac valve replacement with CPB,were randomly divided into 3 groups (n =15 each) using a random number table:control group (group C),and different doses of rHuEPO groups (EPO1 group,EPO2 group).In EPO1 and EPO2 groups,rHuEPO 40 and 80 IU/kg were injected intravenously before anesthesia induction,respectively.Before anesthesia induction (T0,baseline value),immediately after endotracheal intubation (T1),immediately after aortic cannulation (T2),immediately after cannulation of superior and inferior vena cava (T3),immediately after the beginning of CPB (T4),when each index was decreased to the minimal value during CPB (T5),after rewarming to 36.5 ℃ (T6),immediately after termination of CPB (T7),and at 1 h after termination of CPB (T8),regional cerebral oxygen saturation (rSO2),tissue hemoglobin index (THI),and changes in concentrations of oxyhemoglobin (△ O2Hb),deoxyhemoglobin (△ HHb) and total hemoglobin (△ cHb) in bilateral frontal lobes were recorded.The patients whose minimal rSO2 ≤ 50％ and decrease in minimal rSO2 ≥ 20％ of the baseline value (△rSO2) were recorded.At T0,T8 and 2 h after termination of CPB (T9),venous blood samples were taken for determination of serum concentrations of S100 protein and neuron-specific enolase (NSE) by ELISA.At 1 day before surgery and 8 days after surgery,the patient's cognitive function was assessed using Mini-Mental State Examination,the Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised (WAIS-R),the Digit Symbol subtest of the WAIS-R,the Trailing Making Test (Part A)and the Stroop Color Word Interference Test,while depression and anxiety were assessed by Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scale,respectively.The occurrence of postoperative cognitive dysfunction was recorded.Results There was no significant difference among the three groups in bilateral rSO2 and △ cHb,incidence of bilateral rSO2 ≤ 50％ and postoperative cognitive dysfunction,Zung Self-Rating Depression Scale score,and Zung Self-Rating anxiety Scale score at each time point (P＞0.05).Compared with group C,the incidence of left △ rSO2 ≥ 20％ was significantly decreased,the right △ O2 Hb was increased at T6,8,the serum NSE concentrations were decreased at T9,the serum S100 protein concentrations were decreased at T8,and the number of the Digit Symbol subtest of the WAIS-R completed was increased in group EPO1,and right THI was significantly decreased at T2,T3,T5,T7 and T8,right △ HHb was increased at T2 and T3,and the completion time of Stroop color word interference test B was shortened at 8 days after surgery in group EPO2 (P＜0.05 or 0.01).Compared with group EPO1,the incidence of left △rSO2 ≥ 20％ was significantly increased,the right THI was decreased at T2-4 and T6-8,and the left △ O2 Hb at T6-7 and right △ O2 Hb at T8 were decreased in group EPO2 (P＜0.05).Conclusion rHuEPO 40 IU/kg injected intravenously before induction of anesthesia can mitigate brain injury in the patients undergoing cardiac valve replacement with CPB.

Coronary Sinus ; abnormalities ; Humans ; Male ; Middle Aged ; Subclavian Vein ; Vena Cava, Superior

Objective To explore the relationship bet-ween air pollution and acute onset of cerebral hemorrhage in Hangzhou.Methods Time-stratified case-crossover study was used to analyze the effect of aerosol optical depth(AOD),PM10,SO2 and NO2 on the acute onset of cerebral hemorrhage.Conditional logistic regression was used to estimate the odds ratios(Ors) and their 95% confidence intervals(Cis) in relation to an increase of one unit of AOD and 10 μg/m3 of air pollutants.Results After adjusted temperature and relative humidity,the Ors of acute onset of cerebral hemorrhage by a unit increase in AOD at a 2 day-lag were 1.727(95%CI:1.103-2.703)in first half year and 2.412 (95%CI:1.230-4.733) at a 2 day-lag in spring.For a 10 μg/m3 increase in SO2,the Ors were 1.119(95% CI:1.019-1.229),1.230(95%CI:1.092-1.386),1.254(95%CI:1.076-1.460) in the whole year(2 day-lag),in first half year(2 day-lag) and in spring(2 day-lag),respectively.NO2 exposure in first half year(2 day-lag) was associated with cerebral hemorrhage,with OR as 0.841(95% CI:0.734-0.964).However,there were no statistical significances for AOD,SO2,NO2 in the rest time-periods(P>0.05).Additionally,no association was found between PM10 and the acute onset of cerebral hemorrhage in any time-periods(P>0.05).Conclusion Our data showed that there was association between air pollution and the acute onset of cerebral hemorrhage,especially in spring and in the first half of the year.

Adult ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Female ; Ganglioglioma ; metabolism ; pathology ; surgery ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Magnetic Resonance Imaging ; Phosphopyruvate Hydratase ; metabolism ; Synaptophysin ; metabolism

OBJECTIVETo explore the scavenging action of tenuigenin (TEN) on intracerebral amyloid β protein (Aβ) aggregation and the abnormal phosphorylated tau protein and its mechanism in Alzheimer's disease (AD) rats' brain.

METHODSAβ1-40 was injected into the right CA1 region hippocampus to establish the AD model. Successfully modeled rats were divided into the model group, the low, middle, high TEN group. Rats were administered with TEN (18.5, 37.0, 74.0 mg/kg) by gastrogavage. Besides, a sham-operation group was set up. Expression levels of Aβ1-40 and Tau p-Ser262 were detected by immunohistochemistry. Expression levels of ubiquitin (Ub) and Ub-protein ligase E3 were measured by Western blotting.The content of 26S proteasome was detected by ELISA.

RESULTSImmunohistochemical results showed that the number of Aβ and Tau p-Ser262 positively reacted neurons significantly increased in model group, when compared with the sham-operation group (P < 0.01). Results of Western blot showed expression levels of ubiquitinated protein were up-regulated and those of Ub-protein ligase E3 were down-regulated in the model group (P < 0.01). ELISA results showed that the content of 26S proteasome significantly decreased in AD rats' brain (P < 0.01). Compared with the model group, expression levels of Aβ1-40, Tau p-Ser262, and Ub significantly decreased; expression levels of Ub-protein ligase E3 apparently increased; the content of 26S proteasome significantly increased in each TEN treatment group (P < 0.05, P < 0.01). Best effect was shown in 37.0 mg/kg and 74.0 mg/kg TEN groups.

CONCLUSIONSUb proteasome pathway (UPP) participated in the occurrence of AD. TEN could obviously reduce intracere- bral Aβ1-40 accumulation and abnormal tau phosphorylation.

Alzheimer Disease ; metabolism ; Amyloid beta-Peptides ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Hippocampus ; metabolism ; Neurons ; metabolism ; Phosphorylation ; Proteasome Endopeptidase Complex ; metabolism ; Rats ; Ubiquitin-Protein Ligases ; metabolism ; Ubiquitins