Objective To observe different effects of cyclic and continuous nutrition infusion on serum nutritional indicators, peripheral white blood cell counts (WBC), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ ) score in patients with mechanical ventilated respiratory failure (MVRF).Methods A cross-over and self-controlled trial was conducted in 48 patients with MVRF treated in a medical intensive care unit during December 2006 to June 2009, and continuous nutrition (group A) and cyclic nutrition (group B) were infused respectively for patients of the two groups.Serum levels of albumin (ALB), pre-albumin (PA), transferrin (TR), PaO2, PaCO2, WBC and APACHE Ⅲ score were measured for the patients with 24-hour continuous nutrition (group A) and 16-hour cyclic nutrition (group B)infusion.Effects of the two nutritional therapies were compared.Results After nutrition infusion, serum levels of ALB, PA and TR were (34±3)g/L, (196±28)mg/L and (2.1±0.3 ) g/L in group A, and (35 ±4) g/L, (198 ±25) mg/L and (2.0 ±0.4) g/L in group B, respectively; and PaO2 and PaCO2levels were (92 ± 12) mm Hg ( 1 mm Hg =0.133 kPa) and (42 ± 10) mm Hg in group A, and (91 ±9)mm Hg and (42 ± 10) mm Hg in group B, respectively.WBC and APACHE Ⅲ score were ( 11.8 ± 1.7) ×109/L and 38 ±7 in group A, and ( 12.6 ± 1.2) × 109/L and 40 ±6 in group B, respectively.Significant difference in serum levels of PA and TR was found between the two groups (PPA =0.019 and PTR =0.013),while there was no significant difference in other indictors between the two groups.Conclusions 24-hour continuous nutrition infusion for patients with MVRF can obviously improve their serum levels of PA and TR,but has no effect on serum level of ALB, PaO2, WBC and APACHE Ⅲ score in critical ill patients, as compared to those with 16-hour cyclic nutrition infusion.

Objective To explore the comprehensive approach of rhinoplasty using autologous costal cartilage and e-PTFE,and to observe the outcome and possible complications.Methods A 3-4 cm long costal cartilage was taken out mostly from the 6th or 7th rib and then divided into several parts and shapes.Structural reconstruction of the nasal tip was then done with these costal cartilage parts.Radix augmentation was conducted with e-PTFE.Results From Jan.2013 to Sept.2014,48 patients were treated with this method,all females,aged 22-35 years.36 of them had received rhinoplasty before,12 of them received none.Satisfying aesthetic contouring of the nasal tip and dorsum had been achieved in 45 patients.Deviation of the collumella and nostril asymmetry were found in 3 patients.Among all patients,no such complications as pneumothorax,hemothorax,infection,or hemotoma were observed.The scar on the donor site was not obvious.Conclusions Costal cartilage is sufficient,supportive and easily shapable,when applied to the structural reconstruction of the nasal tip,which can meet the demands of patients who prefer more outstanding and delicate nasal tip contouring.

Objective To evaluate the effect of double L-shape osteotomy combined bony Z-plasty for prominent malar complex.Methods Thirty-two patients with prominent malar complex were treated with double L shape osteotomy combined bony Z plasty for prominent malar complex.Width of lower face was observed during follow-up phase.Questionnaires were used to assess the patents' level of satisfaction at 6 months after operation.Results All wounds got primary intention healing and no severe complication in perioperative period.Postoperative appearance of all 32 cases showed that the width of middle face was efficiently reduced.All patients expressed high levels of satisfaction 6 months after operation.Conclusions Double L-shape osteotomy combined bony Z-plasty for prominent malar complex is an effective and safe method for the treatment of prominent malar complex.

AIM: To study the protective effect and mechanism of panax notoginseng saponinsa(PNS) for dealing with rats with middle cerebral artery ischemia reperfusion(CI/RP). METHODS: To establish the rat middle cerebral artery ischemia/reperfusion model with suture occlusion technique and record the neurologic impairment evaluation score on the basis of Zea Longa method,measured the infarct volume,and the others were detected neuron apoptosis by TUNEL technology and endogenous brain-derived neurotropic factor(BDNF) expression by immunohistochemistry technology. RESULTS: The administration of PNS to rat decreased neurologic impairment,reduced infarct volume,inhibited the neuron apoptosis,and increased endogenous BDNF expression after 24 hours CI/RP. CONCLUSION: Increasing endogenous BDNF expression after CI/RP might be the mechanisms of PNS for achieving neuroprotections.

Tramadol and its metabolites in rat urine were identified by LC-MS(n). Rat urine samples of 0-36 h were collected after ip 9.0 mg x kg(-1) tramadol, then the samples were enriched and purified through solid-phase extraction cartridge. Purified samples were analyzed by LC-MS(n). Possible metabolites were discovered by comparing the full scan and SIM chromatograms of the test samples with the corresponding blanks and analyzing the retention time, quasi-molecular ion and fragment ion of all chromatograms. Nine phase I metabolites and four phase II metabolites were identified in rat urine. One of the metabolites was found first time in living body. The metabolites were formed via the following metabolic pathways: O-demethylation, N-demethylation, hydroxylation, N-oxidation and conjugation. The method can be used to identify tramadol and its metabolites in other animals and human.

Objective To elucidate the prevalence and clinical characteristics of human metapneumovirus(hMPV)in hospital- ized children with respiratory infection.Methods A total of 452 hospitalized children with lower respiratory tract infection were observed from Aug 2004 to Jan 2005.Respiratory tract aspirates were collected from all patients within 48 hours after admis sion.The specimens were routinely tested for respiratory syncytial virus,influenza virus A and B,parainfluenza virus 1 to 3 and adenovirus by direct fluorescent assay(DFA).The 245 specimens negative by DFA were tested for hMPV by RT-PCR. PCR products of hMPV M gene from some patients were randomly selected for sequencing analysis.Results hMPV was identi- fied in 59(24.1%)of the 245 specimens tested,hMPV infection alone accounted for 13.1% of the infections in the 452 chil- dren under study,The prevalence of hMPV was higher than other respiratory viruses in winter.The mean age of hMPV-infec- ted children(n=59)was 27.7 months.There was no significant difference between age groups in terms of the prevalence of hMPV(P＞0.05).There were no statistically significant difference in demographics and clinical symptoms between hMPV in- fection and other common respiratory virus infection.Genotyping for the hMPV M gene from 23 Shanghai patients showed two distinct hMPV genotypes.Sequence analysis of these hMPV M genes showed 82.8%-100% homology to the registered se- quence in GenBank.There was no significant difference in clinical characteristics between the 2 genotypes.Conclusions hMPV plays an important pathogenic role in lower respiratory tract infection of children,hMPV prevailed in the winter of 2004.Clini- cally,hMPV infection can not be discriminated from the infection of other respiratory viruses.Clinical manifestation is similar between the two hMPV genotypes.

Objective To establish a TaqMan real-time fluorescent quantitative PCR to detect Vibrio vulnificus based on hemolysin gene(vvhA)that coding cytolysin.Method By using software Primer Express, the PCR primers and TaqMan probe,which located in the conserved region of vvhA gene sequence,were designed for establishment of a TaqMan real-time fluorescent quantitative PCR to detect 100 bp amplicon from V.vulnificus DNA.A recombinant plasmid pMD19-vvhA100 as a positive control during detection was constructed using gene cloning technique.Minimal amplification cycles(Ct value)and fluorescence intensity enhancement (△Rn value)were used as observing index to optimize the reaction conditions of the TaqMan real-time fluorescent quantitative PCR.The DNAs with different concentrations from V.vulnificus and other eight bacteria and pMD19- vvhA100 were applied as templates to determine the specificity,sensitivity and reappearance of the TaqMan real- time fluorescent quantitative PCR.ICR mice were intraperitoneally,subcutaneously and orally infected with V. vulnificus,respectively.The detection effect of the TaqMan real-time fluorescent quantitative PCR was measured using the specimens of peripheral blood,subcutaneous tissue and intestinal content collected from the infected mice.Results The established TaqMan real-time fluorescent quantitative PCR showed positive results only for V. vulnificus DNA and pMD19-vvhA100.The detection effectiveness of the TaqMan real-time fluorescent quantitative PCR was as high as 0.01 ng of V.vulnificus DNA or 103 copies of pMD19-vvhA100.The SD values of the detection results repeated for three times using pMD19-vvhA100 with different concentrations were lease than 0.79. The detection results of TaqMan real-time fluorescent quantitative PCR were positive for all the specimens of peripheral blood and subcutaneous tissue.Conclusions The TaqMan real-time fluorescent quantitative PCR established in this study for V.vulnificus vvhA gene detection has advantages such as quickness,stability, sensitivity and specificity,indicating this method can be used for clinical laboratory diagnosis of septicemia and wound infection caused by V.vulnificus.

Objective To summarize the clinical characteristics,diagnosis and treatment of pulmonary sequestration(PS) in children.Methods The clinical data of 19 children with PS confirmed by operation and(or) imaging examination from Mar.2003 to May.2008 were analyzed retrospectively.Thirteen cases were male,and 6 cases were female.One case was newborn infant.Seventeen cases received operation.Intralober type had a pulmonary lobectomy and extralobar type had a sequestrectomy.Chest X-ray and CT scan examinations were performed on the patients before operation.Results Seventeen cases got complete cure by operation,and the mean age at operation was 5.2 years.Chest enhanced CT indicated abnormal feeding arteries.Lobectomy was performed in 13 cases of intralobar PS,4 cases of extralobar PS were resected in the separated lung tissue,and all patients had unilateral lesions.No late deaths occurred in this group except 1 case who was complicated with malformation,and the postoperative follow-up showed an excellent recovery.Conclusions The main diagnostic methods of PS are CT and angiography.The diagnosis of PS can be confirmed when systemic feeding arteries are indicated on enhanced CT scans.Surgical resection is the main choice of treatment in all cases of PS in order to prevent recurrent infection and hemoptysis.The excellent results can be obtained by surgery.

Objective To evaluate engraftment status of patients after allogeneic hematopoietic stem cell transplantation(Allo-HSCT) and prompt relapse of disease based on DNA polymorphism analysis technique.Methods Sixty-six cases were detected by DNA polymorphism analysis technique and 25 cases were monitored and analyzed dynamically during this period.Results After Allo-HSCT,48 patients obtained type of donors,but 13 patients did not; 5 patients showed mixed chimerism.Two cases of type of donors converted into mixed chimerism and 4 cases of mixed chimerism converted into type of donors after some time. The others' engraftment status did not change.Conclusion DNA polymorphism analysis technique can detect engraftment status of patients exactly, rapidly, which provides effective evidences of constitution for more clinical therapy projects.

Adolescent ; Diagnosis, Differential ; Endometriosis ; pathology ; Female ; Humans ; Melanoma ; pathology ; Melanosis ; complications ; pathology ; surgery ; Ovarian Neoplasms ; complications ; Peritoneal Diseases ; complications ; pathology ; surgery ; Teratoma ; complications