Objective To evaluate the effectiveness of noninvasive positive pressure ventilation(NPPV) as a weaning strategy in patients with acute respiratory failure after failure to wean from invasive positive pressure ventilation(IPPV). Method A prospective randomized and controlled clinical trial of weaning of IPPV was carried out in patients mechanically ventilated in mode of IPPV for more than 48 hours with failure in a spontaneous breathing trial(SBT: PSV 6 cmH_2O). Patients with contraindications to NPPV were excluded. After failure the SBT, patients were randomly divided(random number) in two groups. Patients in NPPV group were extubated after being ventilated with high pressure support for 30 minutes and then placed on NPPV. Patients in IPPV group were weaned following conventional procedure. Arterial blood gases, maximal inspiratory pressure, respiratory rate,tidal volume, rapid shallow breathing index, heart rate, arterial blood pressure, and peripheral oxygen saturation were measured before and after failing the SBT. The rate of complications, including pneumonia and tracheotomy duration mechanical ventilation, days of hospital stay and outcome were observed. Findings of the two groups were vompared using the Student t test and the chi-square test. Results The percentage of complications in the NPPV group was lower(22.9% versus 72.2%, P <0.01) ,with lower incidences of pneumonia(6.1%,36.1%; P <0.01) and tracheotomy. Compared between the two groups, days of ICU stay( 14.16(3.45) d vs. 22.57( 7.71 ) d; P <0.01) and total days of mechanical ventilation(14.88±3.76 days vs. 20.68± 2.79 days, P <0.01) of NPPV group are shorter than IPPV group. Conclusions NPPV is a good alternative to the mechanically venti-lated patients who fail in initial weaning attempts. The key to successful NPPV weaning is the proper selection of weaning candidates and using NPPV as soon as possible after extubation.

Objective:The effect of Tonglin capsule was observed on type steblay interstitial nephritis of cavy.Methods: The cavy was immunized using the basement membrane of renal tubule from renal cortex of rabbit and Freund's complete adjuvant (FCA). The animal model of autoimmunity renal tubule interstitial nephrifis was made, The effect of Tonglin capsule on nephric pathological changes was observed. Results: ① The levels of creatinine (Cr) and blood uria nitrogen (BUN) in treatment groups were obviously lower than that in model group ( P

Objective To evaluate the predictive performance of diaphragm thickening fraction ( DTF) assessed by ultrasound in the feasibility of weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease ( COPD ) . Methods Forty-three patients with COPD were enrolled for prospective study.All patients were ventilated mechanically for more than 48 hours and were expected to be weaned when they met clinical criteria in the intensive care unit from February 2015 to August 2015.Patients received a spontaneous breathing trial under pressure support for 1 h.At the end of spontaneous breathing trial, the right hemi-diaphragm was visualized in the zone of apposition using a 6-13 MHz linear ultrasound probe. Diaphragm thickness was recorded at end-inspiration (DTei) and end-expiration (DTee), and the DTF was calculated as percentage from the following formula:(DTei -DTee) /DTee.Also the rapid shallow breathing index ( RSBI ) was calculated.Patients meeting weaning criteria were extubated.Weaning successfully was defined as spontaneous breathing for >48 h without any form of ventilation support.Results Twenty-five patients were weaned successfully and failure of weaning was found in 18 patients.A significant differences in DTF ( 39.66 ±13.22 )%vs.( 23.84 ±8.85 )%, P <0.05 and RSBI ( 62.74 ±26.05 ) vs.( 98.89 ± 35.44) , P <0.05 were observed between patients with successful weaning and patients with failure.The sensitivity and specificity of DTF≥30 % for successful weaning were 84% and 83.88 %, respectively.The area under the receiver operating characteristic curve was 0.872 ( 95 % CI: 0.759-0.985 ) for DTF.By comparison, when RSBI was ≤105, there was a sensitivity of 92 %, and a specificity of 38.89 % for determining successful weaning.The area under the receiver operating characteristic curve was 0.804 ( 95 %CI: 0.669-0.940) for RSBI. Conclusions This study shows that in a cohort of COPD patients, the assessment of DTF using diaphragm ultrasound may be useful to predict success weaning or failure during spontaneous breathing trial.

[ ABSTRACT] AIM: To explore the relationship between FRAS 1 protein and brain metastases of non-small cell lung cancer (NSCLC).METHODS:The mRNA expression of FRAS1 in the brain metastatic tumor tissues and primary tumor tissues of NSCLC was detected by qPCR .The protein expression of FRAS 1 in the tumor tissues and normal tissues adjacent to tumor tissues of NSCLC was measured by SP method of immunohistochemistry .The protein expression of FRAS 1 in NSCLC primary tumor tissues with or without brain metastases was also determined .RESULTS:The mRNA expression of FRAS1 in the brain metastatic zone was nearly 10 times higher than that in the primary tumor tissues , and there was sig-nificant difference between the 2 groups (P<0.05).FRAS1 protein was expressed in the NSCLC primary tumor tissues , but was not found in the normal tissues adjacent to primary tumor tissues .The protein expression of FRAS 1 in the NSCLC with brain metastases was significantly higher than that without brain metastases ( P<0.01 ) .CONCLUSION: FRAS1 protein may be associated with the occurrence of NSCLC .The over-expression of FRAS1 protein may be related to brain metastases with NSCLC .

A case of Langerhans cell histiocytosis of the mandible was reported. A 34-year-old woman presented with pain for one year on the gingival of the low left jaw, and together with pyorrhea in the past 2 months. The histopathology and immunohistochemical examination confirmed the diagnosis of Langerhans cell histiocytosis.
Adult ; Female ; Gingiva ; Histiocytosis, Langerhans-Cell ; Humans ; Mandible

OBJECTIVETo investigate the burden of infectious disease of the Chinese population in 1990 and 2010 and changing pattern in the past 20 years.

METHODSResults of the Global Burden of Disease Study 2010 (GBD 2010) were used to demonstrate the burden of infectious disease of the Chinese population in 1990 and 2010 and changing pattern from 1990 to 2010 by gender and age groups, including indicators of incidence, mortality, years of life lost due to premature mortality (YLL), years lived with disability (YLD), disability-adjusted life years (DALY), and their age-standardized rates using data of the 2010 National Census as a standard population.

RESULTSIn 1990 incidence, standardized incidence rate, mortality, standardized mortality rate, DALY, standardized DALY rate, YLL, standardized YLL rate, YLD, and standardized YLD rate of infectious disease in China were 3 067 469 200 cases, 242 669.34 cases/100 000, 824 300 cases, 72.27 cases/100 000, 58 937 700 person-years (PYRS), 3 992.85 PYRS/100 000, 46 504 100 PYRS, 2 932.99 PYRS/100 000, 12 433 600 PYRS, and 1 059.86 PYRS/100 000, respectively. All the aboved indicators were declined from 1990 to 2010, in 2010 they were 3 065 985 800 cases, 224 351.66 cases/100 000, 388 600 cases, 30.74 cases/100 000, 19 492 200 PYRS, 1 440.75 PYRS/100 000, 12 045 700 PYRS, 891.87 PYRS/100 000, 7 446 500 PYRS, and 548.89 PYRS/100 000, respectively. When 2010's indicators were compared to those in 1990, the rates of increase of incidence, incidence rate, mortality, mortality rate, DALY, DALY rate, YLL, YLL rate, YLD, and YLD rate were 56.84%, -9.85%, -33.07%, -61.54%, -27.68%, -58.42%, -32.46%, -61.17%, -16.75%, and -52.13% for 50-69 age group; for &ge; 70 age group, 57.90%, -5.86%, 7.41%, -36.12%, -5.00%, -43.51%, -5.14%, -43.59%, -4.52%, and -43.2%.

CONCLUSIONSThe burden of infectious disease of the Chinese population was declined from 1990 to 2010; however, the incidence of infectious disease was increased in &ge; 50 age groups.

Asian Continental Ancestry Group ; China ; Communicable Diseases ; Cost of Illness ; Disabled Persons ; Humans ; Incidence ; Mortality ; Quality-Adjusted Life Years ; Reference Standards

Objective:To investigate the status of corneal epithelial remodeling and changes in corneal aberration after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and FS-LASIK combined with corneal collagen cross-linking (FS-LASIK Xtra), and to analyze the relationship between corneal epithelial thickness (CET) and corneal aberration.Methods:A cohort study was conducted.A total of 172 patients (172 eyes) who underwent FS-LASIK at Yinhai Eye Hospital of Chengdu University of Traditional Chinese Medicine were enrolled from June 2021 to February 2022.The 172 eyes were divided into FS-LASIK group (94 eyes) and FS-LASIK Xtra group (78 eyes) according to the surgical procedure, with a total follow-up of 6 months.The cornea was divided into a central 2-mm ring and a ring of 2-5 mm centered on the central cornea.CET at 9 regions in the central 0-5 mm area was measured by OCT before and at 1, 3 and 6 months after surgery, and the corneal higher-order aberration (HOA) was measured by the iTrace visual function analyzer.The main outcomes were the increase in CET (ΔCET), and corneal HOA at 6 months after surgery.The relationship between central corneal ΔCET and corneal aberration was analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Yinhai Eye Hospital of Chengdu University of Traditional Chinese Medicine (No.2021yh-009). Written informed consent was obtained from each subject.Results:At 1, 3 and 6 months after surgery, the central, superior, superior nasal, nasal, inferior nasal, inferior, inferior temporal, temporal and superior temporal ΔCET were significantly smaller in FS-LASIK Xtra group than in FS-LASIK group (all at P<0.05). In FS-LASIK Xtra group, 6-month postoperative central, superior, superior nasal, inferior and inferior temporal ΔCET were significantly larger than those at 1 month after surgery, and 3- and 6-month postoperative temporal ΔCET were significantly larger than that at 1 month after surgery, and 6-month postoperative superior temporal ΔCET was significantly larger than those at 1 and 3 months after surgery (all at P<0.05). In FS-LASIK group, 3- and 6-month postoperative central, superior, inferior and inferior temporal ΔCET were significantly larger than those at 1 month after surgery, and 6-month postoperative superior nasal ΔCET was significantly larger than that at 3 months after surgery, and 6-month postoperative nasal, inferior nasal, temporal, superior temporal ΔCET were significantly larger than those at 1 and 3 months after surgery (all at P<0.05). There was no significant difference in vertical trefoil, vertical and horizontal coma changes at different time points after surgery between both groups (vertical trefoil: χ2group=4.27, P=0.118; χ2time=0.01, P>0.05.vertical coma: χ2group=5.74, P=0.057; χ2time=0.08, P=0.957.horizontal coma: χ2group=3.97, P=0.137; χ2time=0.51, P=0.773). The tilted trefoil changes at 1, 3 and 6 months after surgery of FS-LASIK Xtra group were significantly larger than those of FS-LASIK group (all at P<0.05). The 6-month spherical aberration change in FS-LASIK Xtra group was significantly higher than that at 1 month after surgery, and the 6-month spherical aberration change in FS-LASIK group was significantly higher than that at 1 and 3 months after surgery (all at P<0.05). The 6-month total HOA change in FS-LASIK group was significantly lower than that at 1 and 3 months after surgery (all at P<0.05). In FS-LASIK group, central corneal ΔCET was weakly positively correlated with spherical aberration at 1 and 6 months after surgery ( rs=0.257, P=0.008; rs=0.244, P=0.012), and was weakly positively correlated with total HOA ( rs=0.253, P=0.009; rs=0.279, P=0.004). Conclusions:The postoperative ΔCET after FS-LASIK Xtra is smaller than that after FS-LASIK, but the homogeneity of ΔCET in each region is similar between the two groups.The changes in corneal HOA after surgery are similar in both groups, and there is a certain association between the overall epithelial distribution and corneal aberration.

Objective To investigate the burden of infectious disease of the Chinese population in 1990 and 2010 and changing pattern in the past 20 years. Methods Results of the Global Burden of Disease Study 2010 (GBD 2010) were used to demonstrate the burden of infectious disease of the Chinese population in 1990 and 2010 and changing pattern from 1990 to 2010 by gender and age groups, including indicators of incidence, mortality, years of life lost due to premature mortality (YLL), years lived with disability (YLD), disability?adjusted life years (DALY), and their age?standardized rates using data of the 2010 National Census as a standard population. Results In 1990 incidence, standardized incidence rate, mortality, standardized mortality rate, DALY, standardized DALY rate, YLL, standardized YLL rate, YLD, and standardized YLD rate of infectious disease in China were 3 067 469 200 cases, 242 669.34 cases/100 000, 824 300 cases, 72.27 cases/100 000, 58 937 700 person?years(PYRS), 3 992.85 PYRS/100 000, 46 504 100 PYRS, 2 932.99 PYRS/100 000, 12 433 600 PYRS, and 1 059.86 PYRS/100 000, respectively. All the aboved indicators were declined from 1990 to 2010, in 2010 they were 3 065 985 800 cases, 224 351.66 cases/100 000, 388 600 cases, 30.74 cases/100 000, 19 492 200 PYRS, 1 440.75 PYRS/100 000, 12 045 700 PYRS, 891.87 PYRS/100 000, 7 446 500 PYRS, and 548.89 PYRS/100 000, respectively. When 2010's indicators were compared to those in 1990, the rates of increase of incidence, incidence rate, mortality, mortality rate, DALY, DALY rate, YLL, YLL rate, YLD, and YLD rate were 56.84%,-9.85%,-33.07%,-61.54%,-27.68%,-58.42%,-32.46%,-61.17%,-16.75%, and-52.13%for 50-69 age group;for&ge;70 age group,57.90%,-5.86%, 7.41%, -36.12%, -5.00%, -43.51%, -5.14%,-43.59%, -4.52%, and-43.2%. Conclusions The burden of infectious disease of the Chinese population was declined from 1990 to 2010;however, the incidence of infectious disease was increased in&ge;50 age groups.