Objective To observe the effect of Bi-level positive airway pressure(BiPAP) noninvasive ventilation on acute left ventricular failure(LVF). Methods BiPAP group :32 patients with severe LVF from various causes were treated by BiPAP with traditional drugs. Control group:32 patients were treated with traditional drugs alone,and the results were compared with those of BiPAP group. Results Dyspnea was relieved in all patients in BiPAP group,both the respiratory rate and heart rate were slowed,the vital signs were stable,and PaO2 ,SaO2 went up. The total effective rate was 100%, which was only 68. 75% in control group. Conclusion The use of BiPAP noninvasive ventilation therapy is feasible and effective on LVF.

ObjectiveTo study the relationship between the activity of daily living (ADL) and the physiopsychic variables of the patients at early recovery stage after first stroke. Methods ADL and the motion activities, the deficient degree of nerve function, the cognitive function and the depressive degree of the 48 patients at early recovery stage after first stroke were evaluated. ResultsThere are significant relationship between ADL at early recovery stag and the motion activities, the deficient degree of nerve function, the cognitive function of the patients at acute period(P<0.01). Meanwhile, there are also relationship between ADL and the number of the cerebral lesion, the hemiplegic degree and the education degree of the patients (P<0.05) at early recovery stage.Conclusions The motion activities, the deficient degree of nerve function and the cognitive function of the stroke patients at acute stage are the important predictive factors to ADL of the patients at early recovery stage, and the number of the cerebral lesion, the hemiplegic degree and the educational level of the patients maybe influence ADL of the patients at the early recovery stage.

OBJECTIVETo provide evidence for intervention measures on safe injection through a survey on the safety of injection in the health facilities in Wulong county, Chongqing city, China.

METHODSAn investigation on injection safety was conducted among health care providers with a uniform questionnaire.

RESULTSGlass syringes which were not appropriately sterilized was found in 52.2% (12/23) of the health facilities. Injection practices were not correct in 31.4% (11/35) of the health facilities. Used disposable syringes were discarded directly without any disposal in 63.6% (21/33) of the health facilities. At least one of the unsafe injection practices mentioned above existed in 77.1% (27/35) of the health facilities.

CONCLUSIONSThe main unsafe factors in the practice of injection are included: the practice to change needle but not syringe in penicillin allergic test and the injuries caused by used disposable syringes in medical staff. The important measures to improve injection safety were to train the medical staff on the knowledge about safe injection and the risks caused by unsafe injection, and to equip the health facilities with safe tools to destroy the used disposable syringes.

Adult ; China ; epidemiology ; Cross-Sectional Studies ; Disinfection ; statistics & numerical data ; Disposable Equipment ; statistics & numerical data ; Equipment Reuse ; statistics & numerical data ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Injections ; adverse effects ; statistics & numerical data ; Male ; Risk Factors ; Rural Health Services ; Safety ; Sampling Studies ; Surveys and Questionnaires ; Syringes

OBJECTIVETo explore a way of determining the weights of variables in synthetic evaluation.

METHODSBased on the attribute synthetic evaluation system, similarity weight was used to cluster and rank the atmospheric quality on 11 large cities.

RESULTSRealized the classification and ranking for the atmospheric quality of the cities given, the results were almost comparable to that achieved by Topsis evaluation.

CONCLUSIONThe method of comprehensive assessment using similarity weight in the attribute synthetic evaluation system seemed to be objective and rational. Not only it embodied the weights of variables involved, but also exploiting the information presented by the sample.

Air Pollution ; prevention & control ; statistics & numerical data ; China ; epidemiology ; Data Interpretation, Statistical ; Decision Making ; Environmental Monitoring ; Epidemiological Monitoring ; Evaluation Studies as Topic ; Humans ; Models, Theoretical

OBJECTIVEThe survival rate of cadaveric renal transplant in children has been improved following the development of transplantation technology and the application of immunosuppressive agents. In this study, the prognosis of renal transplantation, operative procedure and immunosuppressive agents administration in 21 children with end-stage renal disease (ESRD) were analyzed.

METHODSFrom January 1985 to December 2001, 21 patients (9 males and 12 females with a mean age of 14 +/- 2 yr, mean body weight of 33.4 kg and mean height of 136.5 cm) received renal transplantation because of ESRD were enrolled in the study. The patients with an average GFR of 8.28 ml/min were managed with dialysis for 13.4 months in average pro-transplantation. All cadaveric kidneys were from adults, which included 1 donor with one HLA mismatch, 3 with two mismatches, 5 with three mismatches and 4 with four mismatches. All transplantations were performed with anastomoses of the adults' renal artery and vein to the children's iliac externa artery and iliac externa vein. Biological inducement therapy was given in 4 cases. At the first 3 - 5 days post-transplantation, methylprednisolone was administered [7 mg/(kg.d)]. All patients received baseline diploid or triple immunosuppression therapy of cyclosporin A [6 - 8 mg/(kg.d)] or FK506 [0.18 - 0.25 mg/(kg.d)], mycophenolate mofetil [MMF 10 - 15 mg/(kg.d)] or azathioprine [1 - 3 mg/(kg.d)] and prednisone [0.4 - 0.6 mg/(kg.d)]. High-dose methylprednisolone [10 mg/(kg.d)] was administered to control the acute rejection.

RESULTSThe renal function of patients was restored 5.6 days in average after transplantations. The 1st, 3rd and 5th year survival rates of recipient/graft were 95.2%/95.2%, 86.7%/73.3% and 72.7%/63.6%, respectively. One case had super-acute renal rejection, 5 cases had acute rejection, 3 cases had delayed graft function and 3 patients died. The longest survival time was 12 years. The major complications included hypertension (47.6%), diabetes (19.4%), infection (19.4%) and drug-induced hepatic injury (14.2%). Catch-up growth was seen in most of the pediatric recipients.

CONCLUSIONRenal transplantation is the most ideal method to treat children with ESRD, and the growth of the pediatric patients will be improved after transplantation. Adult donor kidneys adapt to the school age patient. And the protocol of immunosuppressive therapy (prednisone plus MMF and FK506) should be applied.

Adolescent ; Adult ; Child ; Female ; Histocompatibility Testing ; Humans ; Kidney Failure, Chronic ; mortality ; therapy ; Kidney Transplantation ; Male ; Postoperative Care ; Preoperative Care ; Prognosis ; Survival Rate ; Time Factors

China ; epidemiology ; Communicable Diseases ; epidemiology ; mortality ; Female ; Hepatitis, Viral, Human ; epidemiology ; mortality ; Humans ; Incidence ; Male ; Rabies ; epidemiology ; mortality ; Tuberculosis, Pulmonary ; epidemiology ; mortality

To evaluate the use of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) for treatment of acute and chronic leukemia, from March 1997 to January 2003, 21 adult patients with malignant hematopoietic diseases underwent allo-PBSCT from HLA-identical siblings (19 patients) and haplo-identical mother (one) and one B point site mismatched sibling (one). All donors were mobilized with G-CSF for 4 days and peripheral blood stem cells were collected by CS-3000 separator. The conditioning regimen included the high dose combination chemotherapy and TBI. Cyclosporine-A (CsA) plus a short course of MTX was used for GVHD prophylaxis in all patients. The results showed that after trans plantation, median time for the recovery of granuocyte > or = 0.5 x 10(9)/L and platelets > or = 20 x 10(9)/L were 12 (10 - 20) and 15 (11 - 35) days, respectively. Acute GVHD was observed in 8/17 patients (47%), of which one transplanted from HLA-haploidentical mother. Chronic GVHD occurred in 12/17 patients (70%). All of four female survivals did not show acute and chronic GVHD. Day 100 transplantation-related mortality was 14% (3/21). Relapse occurred in two patients (9.5%) who underwent allo-PBSCT in stage of non-remission at one and six months. After follow-up of 40 (15 - 70) months, 11 patients (52.4%) are still disease-free survival. These results suggested that peripheral blood stem cells produce a faster hematopoietic recovery and a lower relapse of leukemia. The rate of aGVHD is not increased when using the peripheral blood as source of stem cells; however, cGVHD continues to be a significant problem. Donors tolerated the procurement procedure without complications.
Adolescent ; Adult ; Female ; Graft vs Host Disease ; etiology ; Humans ; Leukemia ; therapy ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Transplantation, Homologous ; Treatment Outcome

OBJECTIVETo investigate the prevalence of mutations and sequence variations in X-linked inhibitor of apoptosis (XIAP) gene among Chinese pediatric patients with hemophagocytic lymphohistiocytosis (HLH).

METHODSSixty-five children who were diagnosed with HLH between January 2009 and December 2012 (case group), as well as 70 healthy children (control group), were enrolled in the study. The exons of XIAP gene (1-1, 1-2, 2-6) were amplified by PCR and directly sequenced. The genotypic and allelic frequencies of single nucleotide polymorphism (SNP) were analyzed.

RESULTSNone of the HLH patients showed mutations in these exons of XIAP gene. Only one nonsynonymous SNP, rs5956583 located in exon 5, was observed, but there were no significant differences in the genotypic and allelic frequencies of this SNP between the case and control groups (P>0.05).

CONCLUSIONSHLH caused by XIAP mutations may be rare in children. SNP rs5956583 of XIAP gene may have little contribution to the development of childhood HLH.

Child ; Child, Preschool ; Female ; Humans ; Lymphohistiocytosis, Hemophagocytic ; genetics ; Male ; Mutation ; Polymorphism, Single Nucleotide ; X-Linked Inhibitor of Apoptosis Protein ; genetics

OBJECTIVEAn epidemic of severe acute respiratory syndrome (SARS) hit Beijing, China, between March and July 2003 with an attack rate of 1.9 per 10 thousand. (2,521 cases). To control the epidemic of SARS, a total of 30,173 residents were quarantined either in their residence or in quarantine sites. In order to understand the personal need of being quarantined and to estimate the risk of developing SARS during the quarantine period, a survey on the quarantined residents of Haidian District, Beijing, China was carried out.

METHODS33 precincts in Haidian District divided into five groups (7 in north, 6 in south, 7 in west, 6 in east and 7 in central of Haidian District) according to the location of the precincts were involved. The director of Center of Disease Control and Prevention of Haidian District was asked to select 1 precinct from each group according to the workload of the precinct quarantine officers. From those 5 precincts we obtained lists of all quarantined persons from the precinct quarantine officers. All quarantinees were asked to complete a self-administered questionnaire. The SARS patients were diagnosed and verified according to the diagnosis criteria released by Chinese Ministry of Health which was equivalent to the SARS 'probable case' definition of WHO. All SARS cases had been reported to the relative authorities.

RESULTSBy May 23, 2003, 5,186 persons had been quarantined in Haidian district, accounting for 0.23% of all residents. 1,028 of sampled quarantined residents completed the questionnaire. Of those who completed the questionnaire, 2.3% (95% CI: 1.5% - 3.5%) developed SARS while under quarantine. The median quarantine period was 14 days (range 1 day to 28 days). 61% of the quarantinees had a direct contact history with SARS patients, and all secondary SARS patients developed through contact to these quarantinees. The remaining 39% quarantinees who did not have a direct contact history with SARS patients had not developed SARS during the period under quarantine. 37% of the quarantees had direct contact during original patients' symptomatic period with an AR of 6.3%. Persons who looked after the illed SARS patient(s) during their symptomatic period, had an highest attack rate of 31% (95% CI: 20% - 44%). 63% (95% CI: 60% - 66%) of the total quarantined persons did not have direct contact with a SARS patient during his/her symptomatic period, with an attack rate of 0% (95% CI: 0% - 0.73%).

CONCLUSIONOnly those persons having direct contact with ill SARS patients need to be under quarantine. The overall cost for quarantine on SARS prevention could be reduced by as much as 63% if the quarantine program was limited to this group. No evidence was found that SARS patient was infective during the incubation period.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; prevention & control ; Female ; Humans ; Infant ; Male ; Middle Aged ; Quarantine ; methods ; organization & administration ; psychology ; Risk Factors ; Severe Acute Respiratory Syndrome ; epidemiology ; prevention & control ; psychology ; Time Factors

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hepatitis E ; epidemiology ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Young Adult