Objective To discuss the value of percutaneous dilatational tracheotomy(PDT) for cardiosurgery in intensive care unit by comparing its outcomes with that of open tracheotomy(OT).MethodsA prospective study was conducted on 40 severe patients undergoing cardiosurgery.The patients were divided into PDT(treated from January 2002 to July 2003) and OT groups(treated from August 2003 to February 2008) with 20 cases in each.The operation time,length and heal time of the incision,blood loss,vital signs,and postoperative complications were compared between the two groups.ResultsThe operation time,length and heal time of the incision in the PDT group were significantly different from that in the OT group [(8.8?2.2) min vs(21.5?5.3) min,t=-9.897;(1.3?0.2) cm vs(3.4?0.5) cm,t=-17.440;and(3.9?0.9) d vs(5.9?1.2) d,t=-5.963;P=0.000].One patient in the PDT group(5%) had Ⅱ degree blood loss during the operation that was significantly less than those in the OT group(13 patients,65%,?2=15.824,P=0.000).The level of the vital signs change in the PDT group was significantly milder than those in the OT group [MAP: 1-5 mm Hg(median 2) vs 1-20 mm Hg(median 3.5),Z=-2.959,P=0.003;heart rate: 3-12 beats/min(median 5.5) vs 7-70 beats/min(median 10),Z=-3.956,P=0.000;SpO2: 0-4%(median 2%) vs 0-31%(median 3.5%),Z=-3.548,P=0.000].Furthermore,the rate of incisional leakage of sputum and overall rate of complications in the PDT group were significantly lower than those in the OT group.[1(5%) vs 8(40%),?2=5.161,P=0.023;and 1(5%) vs 12(60%),?2=13.789,P=0.000].ConclusionsPDT is a safe and minimally invasive technique with a high rate of success and low rate of complications.The method is easy to operate,and thus could be a good choice for severe patients after cardiovascular surgeries.

Objective To evaluate the application of video-assisted thoracoscopic surgery (VATS) in the treatment of traumatic hemothorax. Methods We performed VATS in 60 cases of traumatic hemothorax with medium amount of bleeding or above from March 2000 to March 2004, including 12 cases accompanying the prodrome of shock and 6 cases associated with injuries of liver or spleen. Unilateral VATS was carried out in 48 cases, all of which were completed under thoracoscope except 3 cases of heart injuries were supplemented with mini-incision repair. Bilateral VATS was conducted in 6 cases and the combination of thoracoscopy with laparoscopy was required in 6 cases. Results The operation time was 45～175 min (mean, 105 min) and the postoperative hospital stay was 7～13 days (mean, 11 days). No complication occurred. Conclusions VATS in the management of traumatic hemothorax is safe, effective and minimally invasive, with a relatively short operation time and quick recovery.

Through the Introduction of the visualization technology based on VREL and its application in ultrasound teaching,the teaching means has been changed,the teaching content enriched and the contact between basic and clinic knowledge enhanced,which indicates that the visualization technology exerts an important role in ultrasound teaching.

This article introduces the way of making and using ultrasound multimedia courseware,which can improve teaching means,enrich teaching contents,activate classroom atmosphere and enhance the connection of basic and clinical knowledge.Meanwhile,the environment request of the demonstration courseware and interaction courseware as well as the necessity and significance of multimedia in ultrasound teaching are discussed.It is suggested that computer assisted instruction(CAI) plays an important role in ultrasound teaching.

AIM: To investigate the alteration of the vascular response to contracting material and the endothelium dependent vascular relaxation (EDVR) at different stages of type Ⅱ diabetes rats. METHODS: Type Ⅱ diabetes rat model was established by high-energy diet and lower dose of STZ. At 12th and 20th weekends after injecting STZ, the vascular reactivities to phenylephrine (PHE) and KCl and the EDVR induced by Ach were measured respectively in the isolated aorta rings. RESULTS: At 12th weekend after injecting STZ, the response to PHE increased, the reactivity to KCl kept unchanged, and the EDVR was damaged lightly. But at the 20 th weekend after injecting STZ, the response to PHE increased further and the reactivity to KCl markedly reinforced, and the EDVR was obviously damaged. CONCLUSION: The response of great vessels to contracting material increased, but the EDVR attenuated at different stages of type Ⅱ diabetes rats. These changes are further reinforced along with the developing of disease duration.

AIM: To study the expression of type Ⅰtransforming growth factor ?(T?R-Ⅰ)in renal cortex in streptozotocin-induced type Ⅱ diabetic mellitus and the regulation of valsartan. METHODS: The rat models of type Ⅱ diabetic rats were made. At the end of the 20th weeks,the kidneys were taken out to measure the expression of T?R-ⅠmRNA by RT-PCR. RESULTS: The expression of T?R-ⅠmRNA in diabetic rats without any therapy ( 0.72? 0.14) was higher than that in control ( 0.26? 0.12) (P

Aim To investigate the alteration of the nitric oxide (NO), the expression of nitric oxide synthase (NOS) mRNA at different stages of the cardiomyopathy in type 2 diabetes rats, and the protective effects of valsartan. Methods Type 2 diabetes model was established by high-energy diet, lower dose of STZ treated SD rat. The treatment period of valsartan was 8 weeks. At 12th and 20th weekend after injection of STZ, cardiac function, heart weight index, concentrations of NO in myocardium and plasma, expressions of iNOSmRNA and eNOSmRNA were measured respectively.Results From 12th week to 20th weekend, the left ventricular systolic and diastolic function was decreased and the heart weight index was increased in diabetes control group (DC group) compared with normal control group (NC group). The levels of the cardic tissue and plasma NO were higher at 12th weekend and lower at 20th weekend in DC group than that in NC group. The expression of iNOSmRNA in cardiac tissue was obviously up-regulated at 12th or 20th weekend while the expression of eNOSmRNA was down-regulated at 20th weekend in diabetes rats. All these abnormalities were partially attenuated by valsartan. Conclusion The abnormal change of the NO and expression of NOSmRNA might be related to the cardiomyopathy in type 2 diabetes. Valsartan might play a protective role in the myocardial disease.

Objective To explore the changes of intereferon-?(IFN-?)and interleukin-4(IL-4)in peripheral blood of children with mycoplasma pneumoniae(MP) encephalitis at the acute phase.Methods The peripheral blood concentrations of IFN-? and IL-4 were measured by enzyme-linked immunosorbent assay(ELISA) in 24 cases of children with MP encephalitis at the acute stage.The samples from 24 cases of healthy children were control group.Twenty-four children with MP encephalitis were intravenous drip with azithromycin,at the same time,10 cases received hexadecadrol and 15 cases received gamma globulin.Results The serum concentrations of IFN-? and IL-4 in the mycoplasmal encephalitis group were(98.56?12.93) and(45.55?17.58) ng/L,respectively,which were significantly higher than those in control group [(85.35?6.91) and(26.78?9.89) ng/L] respectively(Pa

The hydrogen peroxide low temperature plasma sterilization technology solved the problems of thermo-sensitive materials' disinfection and sterilization based on its development and unique characteristics. This paper introduced the researches of clinical application quality control, and showed the hydrogen peroxide low temperature plasma sterilizers were being widely used in hospitals and highly recognized. According to the clinical data and the literatures of the domestic equipment in preliminary application, it could be concluded that the technology maturity of domestic hydrogen peroxide low temperature plasma sterilizers was in a high level. The advantages of using domestic hydrogen peroxide low temperature plasma sterilizers to do disinfection and sterilization included lower cost, safer, faster and non-toxic, etc. Also the management system should be improved and the clinical staff should master the technical essentials, obey the procedures strictly, verify periodically and offer full monitoring to upgrade the quality of sterilization.
Cold Temperature ; Disinfection ; instrumentation ; Hydrogen Peroxide ; chemistry ; Plasma Gases ; chemistry

Objective:To study the indicators and operative method of retroperitoneal laparoscopic nephropexy.Methods: From August2001to June2003,8patients with nephroptosis underwent retroperitoneal laparospic nephropexy.All cases were women with an average age of34years(range26-45years).Five cases involved the right kidney,2on the left and1on the both.The presurgical symptoms included constant and recurring pain in8cases,upper urinary infections in6,hematuria in 5,upper tract obstruction in4.A retroperitoneoscopic procedure was performed after positioning the patient in the flank posi-tion.The decisive part was complete exposure exposure within Gerota'fascia to mobilize potential adhesions or the colon,espe-cially to pull inferior blood vessel of the kidney.Nephropexy was performed between the fibrous capsule of the lower pole of the kidney and the dissected psosa muscle using3sutures placed by intracorporeal or extracorporeal technique.Results:The mean operative time was125min(range115-240min);the mean post-operative hospital stay was9d,and the mean bedrest time was7d.During a mean follow-up of12months(range3-20months),1patient complained of recurrent pain,and there was1hematuria.No patient had further episodes of pyelonephritis or upper tract obstruction.IVP revealed kidneys in the af-fected part were in the normal region and greatly improved.Conclusion:Retroperitoneal laparoscopic nephropexy has less trauma,less post-operative discomfort and quicker recovery.It should be considered as the first choice for nephroptosis.[