BACKGROUND: Animal experiments showed that recruitment maneuver (RM) and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index ( EVLWI) in patients with acute respiratory distress syndrome (ARDS). METHODS: Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index (PaO2/FiO2), peak inspiratory pressure (PIP), Plateau pressure (Pplat), static pulmonary compliance (Cst) and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student's t test and Fisher's exact test were used to process the data. RESULTS: The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group (P<0.05). The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group (P<0.05). The EVLWI in the two groups showed downward trend after treatment (P<0.05), and the differences were signifcant at all time points (P<0.01); the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours (P<0.05 or P<0.01). Compared with pre-RM, hemodynamics changes during RM were significantly different (P<0.01); compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM (P>0.05). CONCLUSIONS: RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.

Objective To investigate the method for the normal three‐dimensional ultrasound imaging and the characteristics of the fetal hard palate .Methods 210 single fetus free of deformity were examined using three‐dimensional ultrasound(3DUS) .Offline analysis was made after reconstruction ,the hard palate was observed and the width was measured .Results With reconstruction ,the fetal palate was clearly displayed 1.97 cases in 210 cases were successfully displayed (93 8.% ) .The front palate and both frontalis processus of maxillary bone composed similar triangular structure in the coronal plane .The retral part showed sustained linear hyperechoic and the radian increased along with the gestational age .Early palate showed flaky hyperechoic in the cross section and it became horse‐shoe shaped in the second or third trimester pregnancy surrounded by alveolar bone .Linear regression yielded the following formula for the hard palate width (PW) according to gestational age (GA):PW= -0 5.47+0 0.13 × GA( r =0 9.82 ,P <0 0.01) .Conclusions 3DUS acquired palate images fast and easily .The hard palate in the coronal ,sagittal and cross plane showed obvious characteristic images in different gestational stages .With increasing gestational age ,the curvature ,width ,trend and the contrast with the surrounding tissue had the corresponding changes . The successful three‐dimensional image reconstruction of the postnasal triangle and the retral part of fetal hard palate would have an important significance in terms of assessing its continuity and integrity .

AIM To observe the clinical efficacy of Maixuekang Capsules (hirudin) combined with female progestational hormone treating blood-stagnated cryptogenic hypomenorrhea and their mechanism of action.METHODS Ninty eligible patients were randomly and equally divided into treatment group (Maixuekang Capsules combine with female progestational hormone) and control group (female progestational hormone),treated for three menstrual cycles,the menstrual blood volume,blood D-dimer,maximum platelet aggregation rate,the thickness of endometrium,spiral artery blood flow peak systolic velocity (PSV),resistance index (RI) and pulsatility index (PI) were recorded during the three months period.RESULTS The menstrual blood volume of the two groups were all increased post-treatments (P ＜ 0.05),the treatment group was superior to the control group (P ＜ 0.05);blood D-dimer and maximum platelet aggregation rate of the treatment group had reduced post-treatments (P ＜ 0.05),there was no difference in the two values of the control group between post-treatment and pre-treatment (P ＞ 0.05);the thickness of endometrium of the two groups were both increased after the treatment (P ＜ 0.05),while there was no remarkable statistical difference between the two groups (P ＞ 0.05);RI in the treatment group had remarkable reduction post-treatments (P ＜ 0.05),but there was no remarkable difference of RI in the control group (P ＞ 0.05);there was no statistical difference of PSV and PI in both groups before and after the treatment (P ＞ 0.05).CONCLUSION The combination treatment of Maixuekang Capsules and female progestational hormone can obviously increase menstrual blood volume,improve uterine blood perfusion and endometrial microcirculation.It has more advantages than use hormones alone.

Objective To assess the value of preoperative MRI in predicting the incidence of cement leakage into adjacent discs during percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fracture (OVCF).Methods Clinical and radiological characteristics of 127 patients who were treated with PVA for OVCF were analyzed retrospec tively.The following clinical data of these patients were analyzed,including gender,age,location of treated vertebral body and surgical approach.The image features of endplate injury,fracture line extended to the endplate,adjacent intervertebral dick injury and intravertebral cleft were evaluated on the preoperative MRI.The incidence of cement leakage into the adjacent disc were compared for the above factors with statistical methods.Results Totally 127 patients were enrolled in our study,including 179 treated vertebral bodies,358 endplates and 341 adjacent intervertebral discs.The incidence of intradiscal cement leakage was 57.73％ (56/97) in endplate injury sign,60.98％ (25/41) in fracture line extended to endplate sign,35.91％(51/142) in adjacent discs injury sign and 55.56％(20/36) inintravertebral cleft sign.The differences were statistically significant on preoperative MRI in patients with the above signs compared to those who had not (P＜0.05).The incidence of intradiscal cement leakage in percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) were 26.67％(16/60) and 42.86％(51/119),respectively,which was significant different (P=0.035).For bone cement volume ≤ 5 ml vertebral bodies,the incidence of intradiscal cement leakage was 31.19 ％ (34/109),lower than bone cement volume ＞ 5 ml vertebral bodies (47.14％ [33/70],P=0.031).There was no statistically significant association between intradiscal cement leakage and age,gender and location of treated vertebral body (P＞0.05).Conclusion Preoperative MRI can predict the leakage of bone cement into adjacent discs effectively during PVA.The PKP and the lower volume of bone cement injection can reduce the risk of intradiscal cement leakage.

OBJECTIVETo observe the clinical efficacy of modified Huanglian Wendan Decoction (HWD) in treating senile mild cognitive impairment (MCI) of turbid-phlegm blocking orifice syndrome.

METHODSWith a block randomized, double-blinded and controlled design adopted, the 64 patients of MCI selected from December 2007 to February 2009 were randomly and equally assigned to two groups. The treatment group was treated with HWD in dose of 200 mL, twice a day; the control group was given Aniracetam 0.2 g (for patients over 70-years-old, 0.1 g) three times a day. And the illusive medicine in dosage-form of capsule/decoction simulated to that used in the opposite group was applied. The medication and observation lasted for three months. Chinese medicine syndrome, cognition capacity (by MMSE), laboratory indexes [acetylcholine (Ach), superoxide dismutase (SOD), malondialdehyde (MDA)] and safety related indexes in patients were observed.

RESULTSAfter treatment, MMSE score increased in both groups, but the increment in the treatment group was significantly higher than that in the control group (P<0.01); Chinese medicine syndrome estimated by scoring showed that after treatment, all scores of syndromes, excepting the expectoration, were improved in the treatment group with the post-treatment scores significantly lower than those in the control group respectively (P<0.05 or P<0.01); while in the control group, lowering of scores only showed in some symptoms such as poor memory, heavy head or dizziness, and heavy sensation in limbs and body. Serum levels of Ach and SOD decreased and MDA increased in both groups after treatment, but the change of Ach was more significant in the treatment group (P<0.01). No obvious adverse reactions were found during the treatment.

CONCLUSIONFor treatment of MCI, HWD shows effects in improving patients' symptoms, cognition capacity and elevating serum Ach content better than that of Aniracetam; and with effects for raising SOD activity and reducing MDA level similar to those of Aniracetam.

Aged ; Aged, 80 and over ; Cognitive Dysfunction ; diagnosis ; drug therapy ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Pyrrolidinones ; therapeutic use

Objective To know the quality of iodized salt and the current situation of the salt coverage in Tibet,and to provide scientific basis for proposing proper prevention and control measures to Iodine dificiency disorders(IDD). Methods In 2008, according to the "Sampling Methods of the Main Products in the Salt Industry",one batch fifteen salt samples were collected in iodized salt processing factory in Tibet. Five townships were chosen in each county based on 5 different directions of east, south, west, north and center. If the monitoring county has less than five townships, then all of the townships were sampled. In each township, four villages were selected withrandom sampling and importance sampling. In each township, 15 households were selected for salt collection. Results A batch of 15 salt samples in a salt processing plant were tested, and all of them were qualified with salt iodine(34.6±1.58) mg/kg. A total of 21 107 edible salt samples were tested, and 11 203 of them were qualified iodized salt. These results meant that the provincial iodized salt coverage rate was 53.08%. Shannan iodized salt coverage rate was 94.31% (3395/3600) which was the highest in Tibet. Those of Nagqu, Changdu, Ngari were lower, they were 29.84% (897/3006), 24.94% (823/3300) and 17.08% (205/1200), respectively. Conclusions The quality of iodized salt in Tibet is up to the national standard, but the coverage rate of iodized salt is very low.We suggest that the strategy should be carried out according to the national overall program strategy and supplement iodized oil capsule for special groups.

BACKGROUNDSkin lesions are common manifestations in systemic lupus erythematosus (SLE). It is still unknown what the definite pathogenesis of skin involvement was and whether DNA participated in it. Our study was designed to explore the pathogenetic role and nature of nuclear antigen (DNA) deposited in the skin lesions of patients with SLE.

METHODSThirty skin samples from patients with SLE and 2 normal skin samples were studied. Extracellular DNA was evaluated by indirect immunofluorescence methods. The deposited immune complexes were extracted by cryoprecipitation, and DNA was then isolated with phenol and chloroform. DNA fragment sizes were detected by agarose gel electrophoresis. Finally, 8 different probes were used to analyze the origin of these DNA molecules using Dot hybridization.

RESULTSExtracellular DNA staining was found only in skin lesions, mainly those located in the basement membrane zone, vascular wall, and hair follicle wall. Normal skin and non-lesion SLE skin showed no fluorescence at locations outside the nuclei. There were no differences in the rate and intensity of extracellular DNA staining when comparing active phase to remission phase patients. No relationship was found between extracellular DNA and circulating anti-dsDNA antibodies. Deposited DNA fragments clustered into four bands of somewhat discrete sizes: 20 000 bp, 1300 bp, 800-900 bp, 100-200 bp. Small sized fragments (100-200 bp) were positively correlated with disease activity (P < 0.05, r = 0.407). Dot hybridization showed significant homology of the various extracellular DNA fragments examined with human genomic DNA, but not with DNA from the microorganisms and viruses we examined. There were also homologies between DNA samples from different individuals.

CONCLUSIONSDNA and its immune complexes may contribute to the pathogenesis of skin lesions in SLE. These DNA molecules range in size from 100 bp to 20 kb and may be endogenous in origin.

Antibodies, Antinuclear ; blood ; Antigen-Antibody Complex ; analysis ; DNA ; analysis ; immunology ; Humans ; Lupus Erythematosus, Systemic ; immunology ; Skin ; immunology ; Staining and Labeling

Objective To observe the effects of ultra-wideband (UWB) electromagnetic irradiation on the ultrastructure of pituitary or testis and the serum sex hormones level of in rats. Methods SD male rats were divided randomly into control group and irradiation groups exposed to 3×105 pulses UWB irradiation for 6,12, 24, 48 h. After exposure, the ultrastructure changes of pituitary and testis were observed by electron microscope. Serum testosterone (T) , luteinizing hormone (LH) and follicle stimulating hormone (FSH) were measured by radioimmunoassay. Results The rat pituitary and testis were injured at the different time after exposure to UWB electromagnetic irradiation, but the damage was serious at the 24 h after exposure. In the basophilic cell of the pituitary, there were the vacuoles and lipid droplets, dilated endoplasmic reticulum (ER),exuded lymphocytes and gathered chromatin in the cell border. In the testis tissue, there were the dilated ER and gathered chromatin in the cell border of the spermatogonium, interstitial cell and sustentacular cell, some mitochondria became vacuolar and swollen in the capillary endotheliocytes and exuded lymphocytes. Serum Tlevels of the irradiation groups at 24 and 48 h were ( 1209.7±115.7 ), ( 1340.5±331.1 ) μg/L, which were significantly lower than those[(2721.8± 178.9) and ( 2820.9±321.4 ) μg/L]of control groups at 24 and 48 h (P＜0.05). There was no significant difference for LH and FSH between exposure groups and control groups. Conclusions UWB electromagnetic radiation could induce some changes in the ultrastructure of rat pituitary and testis and serum T level, which may induce the change of reproductive system.

Objective To observe the effects of ultra-wideband (UWB) electromagnetic irradiation on the ultrastructure of pituitary or testis and the serum sex hormones level of in rats. Methods SD male rats were divided randomly into control group and irradiation groups exposed to 3×105 pulses UWB irradiation for 6,12, 24, 48 h. After exposure, the ultrastructure changes of pituitary and testis were observed by electron microscope. Serum testosterone (T) , luteinizing hormone (LH) and follicle stimulating hormone (FSH) were measured by radioimmunoassay. Results The rat pituitary and testis were injured at the different time after exposure to UWB electromagnetic irradiation, but the damage was serious at the 24 h after exposure. In the basophilic cell of the pituitary, there were the vacuoles and lipid droplets, dilated endoplasmic reticulum (ER),exuded lymphocytes and gathered chromatin in the cell border. In the testis tissue, there were the dilated ER and gathered chromatin in the cell border of the spermatogonium, interstitial cell and sustentacular cell, some mitochondria became vacuolar and swollen in the capillary endotheliocytes and exuded lymphocytes. Serum Tlevels of the irradiation groups at 24 and 48 h were ( 1209.7±115.7 ), ( 1340.5±331.1 ) μg/L, which were significantly lower than those[(2721.8± 178.9) and ( 2820.9±321.4 ) μg/L]of control groups at 24 and 48 h (P＜0.05). There was no significant difference for LH and FSH between exposure groups and control groups. Conclusions UWB electromagnetic radiation could induce some changes in the ultrastructure of rat pituitary and testis and serum T level, which may induce the change of reproductive system.