Objective To explore therapeutic effect and side effect of oral indomethacin for treating patent ductus arteriosus(PDA)in full-term infants.Methods Forty-one full-term infants confirmed PDA by echocardiographically,who were admitted to the neonatal intensive care unit of our hospital from Jan.2004 to Dec.2007,were randomly divided into experimental group(21 cases)and control group(20 cases).Three oral doses of indomethacin [0.2 mg/(kg?time),at an interval of 12 hours] were administered in experimental group,while nothing in control group.Hepatorenal function and blood routine were measured in both groups in 2 days before and after treatment.Urine output and level of serum blood sugar were measured,and abdominal distension,vomiting,bloating,and bleeding were recorded during treatment.Color Doppler echocardiographic examination was performed,heart murmur was stethoscopied,and the rate of ductal closure was recorded at 5 to 7 days after treatment.The infants were followed up at out-patient department at 6 to 12 months after treatment,color Doppler echocardiographic examination was performed,and ductal closure condition was recorded.Results Hepatorenal function and blood routine were normal in experimental group in 2 days before and after treatment.Except that a little gastrointestinal bleeding occurred in one case of experimental group after the second dose of indomethacin,other adverse reactions were not observed during treatment.The ductus was closed in 16 infants in experimental group,the rate of ductal closure was 76.19%,while the ductus was closed naturally in 5 infants in control group,the rate of ductal closure was 25.0% at 5 to 7 days after treatment.There was significant difference in the rate of ductal closure between the experimental and control groups(?2=10.74 P

The conception of evidence-based medicine (EMB) has a strong influence on the medical world since it built up.This concept has been widely used in all sorts of clinic and basic medical research,however,it is little reported to be practised in our fundamental medical education.As for it,this article will briefly analyze the importance of introducing the idea into fundamental medical education,and for one thing,suggest some more reform measures for medical teaching staff.

China ; Clinical Trials as Topic ; methods ; Humans ; Organizational Policy ; Publishing ; standards ; Registries

Acute Disease ; Adult ; Brain Diseases ; chemically induced ; Carbon Disulfide ; poisoning ; Humans ; Male ; Occupational Diseases ; chemically induced

Objective To explore the higher dangerous factors,the early clinical performances and its contents of neonatal pulmonary hemorrhage(NPH).Methods The clinical performances,chest radiograms and autoptical pathological materials of 66 cases of newborns who died of NPH at our neonatal department during 1993 to 2003 were reviewed and analyzed.Results The higher dangerous factors of NPH were premature delivery/low birth weight,serious diseases lead to hypoxia and severe infections.The early clinical performances of NPH were the suddenly aggravation of dyspnea and the increasing of moist sounds.The early X-ray performances were lower penetrance of lung fields extensively and well-distributly with path clouds,the intercostals space usually increased.According to the autoptical(patho)-logy,this X-ray perfomance indicated the edema of the pulmonary with small amount of hemorrhage.Conclusion The patients with the higher dangerous factors and the early clinical performances of NPH,must be diagnosed and interfered it as early as possible to reduce the mortality of NPH.

Objective: To study the predictive value of combination scores of leukocyte and platelet counts (COL-P) for in-hospital mortality in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) treatment. Methods: A total of 660 STEMI patients with emergent PCI in our hospital from 2009-11 to 2013-08 were retrospectively studied. The patients were divided into 3 groups according to COL-P scores: COL-P0 group,n=283, COL-P1 group,n=319 and COL-P3 group,n=58. The relationship between the in-hospital mortality and COL-P scores was analyzed among different groups. Results: There were 88/660 in-hospital death. The patients in death group had the higher white blood cell count and lower platelet count than those in survival group, bothP<0.01. Logistic regression analysis indicated that compared with COL-P0 group, the COL-P scores at COL-P1 level (OR 4.346, 95% CI 2.134-8.850,P<0.001) and COL-P2 level (OR 10.126, 95% CI 4.061-25.250,P<0.001) were the independent risk factors for in-hospital death in STEMI patients after emergent PCI. The in-hospital mortality in COL-P0, COL-P1 and COL-P2 groups were at 4.9%, 15.4% and 43.1% respectively, allP<0.001. Conclusion: COL-P score was useful for predicting the in-hospital mortality in STEMI patients after emergent PCI, while the long term mortality estimation should be further studied.

AIM: To evaluate whether tolerogenic dendritic cells (DC) loaded with heat shock protein 60 (HSP60) inhibit the progression of aortic atherosclerotic plaque in hypercholesterolemic apolipoprotein E (Apo-E) -null mice. METHODS: Bone marrow derived DC of the mice were loaded with HSP60 and co-cultured with rapamycin to generate tolerogenic DC. The tolerogenic DC, DC loaded only HSP60 and PBS were injected into the ApoE-null mice at 8 weeks of age for three times at a one-week interval. 8 weeks after the last injection, aorta were harvested for HE staining and anti-CD4~+T cell immunostaining. Responses of pleenic cells to HSP60 were also evaluated. RESULTS: Compared with DC, DC_ HSP60 expressed higher levels of CD86, and stimulated T lymphocytes to proliferation significantly, while the tolerogenic DC expressed lower levels of CD86, and inhibited T lymphocytes to proliferation. After immunization with different injection, the numbers of CD4~+ T cells in plaque were increased significantly in DC_ HSP60 group vs in PBS group (P

Objective To observe the effects of fosinopril(FOS),a new generation angiotensin-converting enzyme inhibitor(ACEI),on protein and mRNA expression of transforming growth factor-?_1(TGF-?_1) of rat glomerular mesangial cell(GMC) induced by lipopolysaccharide(LPS);to demonstrate the preventive mechanism against glomerular sclerosis by applying FOS.Methods The cultured GMC in classic way were divided into 3 groups:control group;LPS group;LPS+FOS group.TGF-?_1 concentration in GMC supernatant fluid was detected by ELISA;TGF-?_1 mRNA expression was determined by semiquantitative real-time RT-PCR.Results LPS group was obviously higher than control groups in TGF-?_1 secretion and mRNA expression,while LPS+FOS group decreased distinctively in TGF-?_1 secretion and mRNA expression compared with LPS group.Conclusions FOS has obviously inhibited on TGF-?_1 expression of rat GMC both at protein level and mRNA level,which reveals that it may be an important mechanism by FOS on restraining the development of glomerulosclerosis.

Objective To discuss the diagnostic value of MRI for portal vein(PV)and superior mesenteric venous(SMV)thrombosis.Methods Twelve patients with portal vein and superior mesenterie venous thrombosis proved by operation and pathology were examined with T_1WI,T_2WI,T_2-weighted fat suppression imaging,MR angiography(MRA)and Gd-DTPA enhanced dynamic MRI.Results Signals in PV and SMV were detected on T_1 WI and T2WI in 12 cases;3 acute thrombus presented hypo-or isointense on T_1 WI and hyperintense on T_2 WI.ttyperintense on T_1 WI and T_2WI were showed in 8 subacute thrombus; 1 chronic thrombus presented heterogenous intense on T_1W1 and hypointense on T_2W1.No enhancement within PV and SMV was found on Gd-DTPA enhanced images.Bowel dilatation was found in 10 cases,bowel hemorrhage in 6,bowel wall thickening in 12,intestinal pneumatosis in 3,ascites in 12,cavernous transformation of the portal vein in 3,hepatic perfusion disorder in 6.Conclusion MRI is an important and sensitive imaging method for the diagnosis and location of portal vein and superior mesenteric venous thrombosis with intestinal ischemia.

OBJECTIVETo explore the relationship of bone cement distribution and the puncture angle in the treatment of thoracolumbar compression fractures with unilateral percutaneous kyphoplasty (PKP).

METHODSThe clinical data of 37 patients with thoracolumbar osteoporotic compression fractures underwent PKP between January 2013 to March 2014 were retrospectively analyzed, all punctures were performed unilaterally. There were 6 males, aged from 65 to 78 years old with an average of (71.83 ± 6.15) years; and 31 females, aged from 57 to 89 years old with an average of (71.06 ± 7.89) years. Imaging data were analyzed and puncture angle and puncture point were measured before operation. According to the measured data, the puncture were performeds during the operation. Distribution area of bone cement were calculated by X-rays data after operation. The effect of bone cement distribution on suitable puncture angle was analyzed; VAS score was used to evaluate the clinical effects.

RESULTSThe puncture angle of thoracic vertebrae in T8-T12 was from 28° to 33° with an average 30.4°; and the puncture angle of lumbar vertebrae in L1-L5 was from 28° to 35° with an average of 31.3°. Postoperative X-rays showed the area ratios of bilateral bone cement was 0.97 ± 0.15. Bilateral diffuse area were basic equal. Postoperative VAS score decreased significantly (1.89 ± 1.29 vs 7.03 ± 1.42).

CONCLUSIONThrough measure imaging data before operation with PKP,the puncture point and entry point can be confirmed. According the measured data to puncture during operation, unilateral puncture can reach the distribution effect of the bilateral puncture in the treatment of thoracolumbar compression fractures.

Aged ; Aged, 80 and over ; Bone Cements ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; methods ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Spinal Puncture ; methods ; Thoracic Vertebrae ; injuries ; surgery