Value of high-flow oxygen therapy after weaning for successful extubation of critical ill patients with mechanical ventilation / 中华危重病急救医学

Objective:To investigate the value of high-flow oxygen therapy after weaning in successful extubation of critically ill patients with mechanical ventilation.Methods:A retrospective study was conducted. The weaned patients who were older than 18 years old and underwent mechanical ventilation for the first time due to cerebrovascular accidents, surgical operations, cardiovascular diseases, and pneumonia admitted to the department of critical care medicine of Zhejiang Hospital from January 2018 to June 2020 were enrolled. Among the patients, 40 cases received high-flow oxygen therapy after weaning, and 37 cases received Venturi combined with the humidifier. The patient's gender, age, primary disease, severity score, duration of mechanical ventilation before weaning, heart rate (HR), blood pressure, pulse oxygen saturation (SpO 2) at 0, 6, 12, 18, and 24 hours after weaning, and pH value, arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2) at 6, 12, 18, and 24 hours after weaning, the rate of performing mechanical ventilation after weaning, extubation time after weaning, and the rate of reintubation after extubation for 72 hours were collected. Results:There was no significant difference in baseline data such as gender, age, primary disease, severity score, and duration of mechanical ventilation before weaning between the two groups. After weaning, the vital signs of the two groups were stable, and there was no significant difference in HR, systolic blood pressure (SBP), diastolic blood pressure (DBP) or SpO 2 at each time point between the two groups. After weaning, the pH of arterial blood gas analysis in the two groups and the fluctuations of PaO 2 and PaCO 2 in the high-flow group were not obvious. In the Venturi group, PaO 2 gradually decreased after weaning, PaCO 2 increased significantly at 12 hours, and slowly decreased after 12 hours. The PaO 2 from 6 hours and PaCO 2 from 12 hours in the high-flow group were significantly lower than those in the Venturi group, and continued to 24 hours [PaO 2 (mmHg, 1 mmHg≈0.133 kPa): 112.34±38.25 vs. 156.76±68.44 at 6 hours, 110.92±38.66 vs. 150.64±59.07 at 12 hours, 111.12±36.77 vs. 141.30±39.05 at 18 hours, 110.82±39.37 vs. 139.65±41.50 at 24 hours; PaCO 2 (mmHg): 41.30±7.51 vs. 47.42±7.54 at 12 hours, 40.97±6.98 vs. 45.83±8.63 at 18 hours, 40.10±7.06 vs. 46.14±9.15 at 24 hours, all P < 0.01]. The rate of performed mechanical ventilation after weaning and the rate of reintubation after extubation for 72 hours in the high-flow group were significantly lower than those in the Venturi group [17.5% (7/40) vs. 40.5% (15/37), 6.2% (2/32) vs. 31.8% (7/22), both P < 0.05], and the extubation time after weaning was significantly shorter than that in the Venturi group (hours: 22.43±11.72 vs. 28.07±10.42, P < 0.05). Conclusion:Using high-flow oxygen therapy to the extubation process of critically ill mechanical ventilation patients can reduce the incidence of carbon dioxide retention and the rate of performed mechanical ventilation after weaning, shorten the extubation time after weaning, and reduce the rate of reintubation after extubation for 72 hours.

A randomized controlled trial: acclimatization training on the prevention of motion sickness in hot-humid environment / 中国应用生理学杂志

<p><b>OBJECTIVE</b>Incidence and severity of motion sickness (MS) in hot-humid environment are extremely high. We tried to know the effect of two-stage training for reducing incidence and severity of ms.</p><p><b>METHODS</b>Sixty male subjects were divided into experimental group and control group randomly. Subjects in experimental group received: (2) adaptation training including sitting, walking and running in hot lab. After adaptation confirmation based on subjective feeling, rectal temperature, heart rate, blood Pressure, sweat rates and sweat salt concentration, we tested both groups by Coriolis acceleration revolving chair test and recorded Graybiel's score and grading of severity to evaluate whether adaptation training was useful; (2) Anti-dizzy training 3m later of deacclimatization contained revolving chair training for 10 times. Then we did the same test as mentioned above to evaluate effect of anti-dizzy training. RESULST: Graybiel' s score and grading of severity had no difference between two groups through acclimatization training (P > 0.05). While they had difference through anti-dizzy training (P < 0.01).</p><p><b>CONCLUSION</b>Adaptation training seems useless for reducing incidence and severity of MS in hot-humid environment, but anti-dizzy training is useful.</p>

Effect of electro-acupuncture at zusanli (ST36) on the expression of ghrelin and HMGB1 in the small intestine of sepsis rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the expression of Ghrelin and high mobility group protein B1 (HMGB1) in the serum and the intestinal tissue of sepsis model rats, and to evaluate the effect of electro-acupuncture (EA) at Zusanli (ST36) on the expression of HMGB1 and Ghrelin.</p><p><b>METHODS</b>Forty-eight male Wistar rats were randomly divided into four groups, i.e., the sham-operation (sham), the cecal ligation and puncture group (CLP), the CLP + EA at Zusanli (ST36) group (EA), and the CLP + Ghrelin receptor blocking agent + EA group (GHSRA), 12 in each group. A sepsis rat model was prepared by CLP. The incision of the abdominal wall was immediately sutured along the ventral midline for rats in the Sham group. In the EA group EA at Zusanli (ST36) was performed 20 min after CLP surgery with the constant voltage (2 - 100 Hz, 2 mA) for 30 min. In the GHSRA group, Ghrelin receptor blocking agent, [D-Arg1, D-Phe5, D-Trp79, Leu11]-substance P (700 nmol/kg), was administered through intravenous injection immediately after CLP, and 20 min later, EA at Zusanli (ST36) was performed in the same way as for rats in the EA group. Blood samples were withdrawn 12 h after CLP. The serum levels of Ghrelin and HMGB1 were detected using ELISA. Ghrelin expressions and the number of Ghrelin immunopositive cell in the jejunum were determined by immunohistochemistry. HMGB1 contents of the jejunum tissue were detected by Western blotting.</p><p><b>RESULTS</b>Compared with the Sham group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased and levels of Ghrelin and the expression rate of immunopositive cells significantly decreased in the CLP group (P < 0.05). Compared with the CLP group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly decreased, but levels of Ghrelin and the expression rate of immunopositive cells significantly increased in the EA group (P < 0.05). Compared with the EA group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased in the GHSRA group (P < 0.05), but there was no statistical difference in levels of Ghrelin between the two groups (P > 0.05). The serum level of HMGB1 was negatively correlated with Ghrelin in the Sham group, the CLP group, and the EA group (r = -0. 528, P < 0.01).</p><p><b>CONCLUSIONS</b>EA at Zusanli (ST36) could inhibit the expression of HMGB1 in the jejunum of septic rats, and promote the expression of Ghrelin. The expression of HMGB1 was inhibited by Ghrelin receptor blocking agent, which suggested that the anti-inflammation of EA at Zusanli (ST36) might be associated with Ghrelin.</p>

Effect of nasal cavity expansion surgery on chronic nasal obstructive diseases on the blood supply of the cerebral arterial system / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of nasal cavity expansion surgery on the abnormal blood supply of the cerebral arterial system.</p><p><b>METHODS</b>Fifty-nine inpatients with abnormal blood supply of cerebral arterial system confirmed by transcranial doppler (TCD) and chronic nasal obstructive diseases were included in this study. All patients accepted nasal cavity expansion surgery and were followed-up with TCD every month after operation until TCD became normal, or up to seven months even if the TCD was still abnormal. SPSS 17.0 software was used to analyze the data.</p><p><b>RESULTS</b>In all 59 patients, there were 164 TCD-abnormal cerebral arteries. Among them, 37 patients(62.71%) with abnormal TCD arteries became normal within 1 to 7 months after operation, 8 patients (13.56 %) got better, but 14 patients (23.73 %) did not improve.</p><p><b>CONCLUSIONS</b>Abnormal blood flow of some cerebral arteries was possibly induced by increasing the activation of sympathetic nervous system around the vertebral arterial system, caused by chronic nasal obstruction. Nasal dilatancy surgery can improve the blood supplement of the cerebral arterial system.</p>

Impacts of electroacupuncture on intestinal permeability in sepsis patients / 中国针灸

<p><b>OBJECTIVE</b>To observe the efficacy of electroacupuncture on sepsis and explore its mechanism.</p><p><b>METHODS</b>Fifty cases were randomized into an observation group (26 cases) and a control group (24 cases). The therapeutic programs of anti-infection, anti-shock, respiratory support and nutritional support were provided, but the drugs that might affect gastrointestinal motility were not prescribed in two groups. In the observation group, on the basic treatment as above, electroacupuncture was applied to Zusanli (ST 36), Tianshu (ST 25), Shangjuxu (ST 37), Xiajuxu (ST 39). The excretion ratio of lactulose to mannitol (L/M) in urine and serum D-lactic acid level were detected before and after treatment, as well as the time of target feeding of the patients in two groups. The efficacy was compared between two groups.</p><p><b>RESULTS</b>After treatment for 3 days, L/M was (0.083 +/- 0.020) and serum D-lactic acid was (0.155 +/- 0.196) mmol/L in the observation group, which were apparently reduced as compared with (0.123 +/- 0.034) and (0.193 +/- 0.377) mmol/L in the control group respectively (both P < 0.05). The time of target feeding was (93.69 +/- 27.58) h in the observation group, which was shortened apparently than (118.17 +/- 40.28) h in the control group (P < 0.05). The total effective rate was 80.8% (21/26) in the observation group, which was better than 54.2% (13/24) in the control group (P < 0.05).</p><p><b>CONCLUSION</b>Conventional treatment combined with electroacupuncture can improve intestinal permeability in sepsis patients, recover intestinal function as quickly as possible to achieve target feeding.</p>

Bilateral maxillary fused second and third molars: a rare occurrence / 国际口腔科学杂志·英文版

This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months.

Report and analysis of periodicals of oral science in China / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To review and analyze the history and current situation of stomatological journals in China from 1949 to 2009.</p><p><b>METHODS</b>The data from journal database, web sites and yearbooks were collected, and the information on Chinese dental journals, national economic indicators and the development in dental disciplines from 1949 to 2009 were obtained.</p><p><b>RESULTS</b>The dental journals numbered one kind, four issues in 1949 and 32 kinds, 204 issues in 2009. China's gross domestic product (GDP) was from 67.9 billion Yuan in 1949 to 30.067 trillion Yuan in 2008.</p><p><b>CONCLUSIONS</b>The quantity of stomatological journals in China has increased remarkably over the past 60 years.</p>

Shear bond strength of anterior teeth fragment reattachment using two different adhesive materials / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To compare the shear bond strength of the fractured anterior teeth reattached by two different adhesive materials.</p><p><b>METHODS</b>Forty crown fractured anterior modes were divided into two groups randomly, with 20 in each group. Group A were reattached by Clearfil SE Bond and Clearfil AP-X, while group B were reattached by Clearfil S3 Bond and Clearfil AP-X. Then the specimens were submitted to an axial compression test in a universal testing machine until tooth fractured. The strength was recorded.</p><p><b>RESULTS</b>The mean shear bond strength of group A and group B was (324.32 +/- 65.91) N and (263.08 +/- 55.88) N, separately. The mean shear bond strength of group A was statistically higher than group B(t = 3.17, P = 0.000).</p><p><b>CONCLUSION</b>The shear bond strength of two-step adhesive Clearfil SE Bond is higher than one-step adhesive Clearfil S3 Bond for the reattachment of fractured anterior teeth.</p>

One-staged correction of alveolar cleft and lip and nasal deformities secondary to lip cleft / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate individualized one-staged correction of alveolar cleft and lip and nasal deformities secondary to lip cleft.</p><p><b>METHODS</b>The alveolar cleft and lip and nasal deformities secondary to lip cleft were corrected in one stage.</p><p><b>RESULTS</b>From 2004 to 2007, 37 cases were treated. 33 patients were treated successfully with primary healing in bony recipient area. Cancellous bone exposure happened in 3 cases. The wounds healed after debridement and drainage. The cosmetic results were satisfactory.</p><p><b>CONCLUSIONS</b>One-staged correction of alveolar cleft and the lip and nasal deformities secondary to lip cleft can achieve good results.</p>

Application of lateral arm free flap in oral and maxillofacial reconstruction following tumor surgery

To describe the application of lateral arm free flap [LAFF] in reconstruction of defects in the oral and maxillofacial regions following ablative oncological surgery. The study included 16 patients [13 male, 3 female, mean age 56, range 35-69 years]. Sixteen LAFF were harvested to reconstruct defects caused by the dissection of malignant tumors of the oral and maxillofacial regions. The tumor was squamous cell carcinoma of the tongue [6 cases], floor of the mouth [4], retromolar area [3], inner cheek [2], and lower gingival [1]. Flap sizes ranging from 5 _ 7 to 6 _ 9 cm were harvested using a sterile tourniquet for bloodless technique. The anastomoses were carried out using a magnifier or microscope. All donor defects were closed primarily. Fourteen flaps healed without venous insufficiency. One flap, in a female patient, survived with mild local microcirculatory obstruction but that of another female patient developed necrosis. There was no significant complication at the donor sites. The advantages of this flap include anatomically reliable vascular supply, accessible donor site, and the aesthetic quality of donor tissue is good. Compared with the radial artery, the posterior radial collateral artery is a nonessential vessel of the arm. The disadvantages are the relatively smaller vessel size for anastomosis and thicker subcutaneous tissue. For the repair of moderate-sized defects of the maxillofacial area, especially in male patients, the LAFF can be recommended

Diagnostic test study of dental operating microscope used for locating the second mesiobuccal canal orifice in maxillary first molars / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To estimate the diagnostic potential of the dental operating microscope used for locating the second mesiobuccal canal (MB2) orifice in maxillary first molars.</p><p><b>METHODS</b>120 extracted maxillary first molars were used, all the access cavities were prepared and fixed on the dental study model. MB2 orifices were examined with naked eye and under a dental operating microscope (DOM). The examination was repeated by another dentist with the same methods. Then Indian ink was injected into the pulp chamber and all the teeth were treated to be transparent to determine if it had a real MB2.</p><p><b>RESULTS</b>The sensitivity and accuracy of the DOM group were 0.78 and 0.76, higher than 0.61 and 0.65 of the naked eye group (P<0.05). The correspondency of Kappa index between observers by naked eye and DOM was 0.701 and 0.819, respectively.</p><p><b>CONCLUSION</b>The use of DOM can increase the detection rate of MB2.</p>

Investigation of root canal curvature of human maxillary first premolar in buccolingual directions / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate root canal curvatures of human maxillary first premolars in buccolingual directions.</p><p><b>METHODS</b>One hundred extracted permanent maxillary first premolars were used. After access preparation, a K-file was inserted into the canals and gently advanced until it reached the apical foramen. Then standardized periapical radiovisiography (RVG) images were taken from mesiodistal direction. The angle of curvature was determined according to the method described by Schneider. The radiu of curvature and length of the curved part of the root canal were calculated.</p><p><b>RESULTS</b>1) The total 50.00% (88/176) of root canal curves were in buccolingual directions, and 53 curves were showed in apical 1/3 of root region. 11.93% (21/176) of S-shaped canals were detected, and the first curves were mostly showed in middle 1/3 of root region, the secondary curves were totally showed in apical 1/3 of root region. 2) There was no difference of curvatures between buccal and lingual root canals, but the secondary curves of S-shaped canals were more complicated than other root canals. 3) There was no correlation between the angle of curvature and the radius of curvature (r=0.002, P>0.05), but significantly correlation between the angle of curvature and length of the curved part of the root canal (r=0.489, P<0.01).</p><p><b>CONCLUSION</b>The occurrence of curved root canals in buccolingual directions may be high in human maxillary first premolars, and the curvatures of S-shaped canals were more complicated than others.</p>

Effect of human semaphorin-3F gene transient transfection on the proliferation of tongue carcinoma cells / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of semaphorin-3F (SEMA-3F) gene transient transfection on the proliferation of Tca8113 tongue carcinoma cells.</p><p><b>METHODS</b>After construction of a full-length SEMA3F expression vector, Tca8113 cells were transient transfected with pEGFP-N1-SEMA3F by Lipofectamine 2000. The expression of SEMA-3F gene was detected by RT-PCR The differences of the expression in the transfected cell groups, empty vector groups and un-transfected cell groups were compared. The survival rates were assayed by methyl thiazolyl tetrazolium (MTT) enzymatic labeling technique. Cell cycle were assayed by flow cytometer (FCM).</p><p><b>RESULTS</b>The gene was transfected into Tca8113 cells. High expression of SEMA-3F was successfully detected in the transfected cell groups after gene transfection. The cell cycle percentage of G1 stage decreased and S stage increased.</p><p><b>CONCLUSIONS</b>SEMA-3F gene transient transfection may inhibit the proliferation of Tca8113 cells.</p>

Mechanism ud protection of electro-acupuncture at Zusanli points(足三星穴) on the apoptosis of thymocytes in rats with severe abdominal infection / 中国中西医结合急救杂志

Objective To study the influence of electro-acupuncture(EA)at Zusanli points(足三里穴) on the apoptosis of thymocytes in rats with abdominal infection and its mechanism.Methods A total of 40 Sprague-Dawley(SD)rats were randomly divided into four groups,including normal control group,model group,non-acupoint group and Zusanli group.The abdominal infection model of rat was made by cecal ligation and puncture(CLP).After abdominal cavity infection for 36 hours,the apoptosis of thymocytes was observed under electron microscope and light microscope,and the apoptosis ratio of thymocytes was determined by Annexin V-PI method with flow cytometry technique.The content of Bcl-2 protein of thymocytes and concentration of corticosterone in plasma were determined.Results Abdominal infection resulted from CLP could significantly increase the apoptosis of thymocytes and lead to the typical histopathological changes of apoptosis of thymocytes under electron microscope and light microscope.Apoptosis ratios of thyrnocytes in model group[(44.7?3.3)%],non-acupoint group[(42.7?3.0)%]and Zusanli group[(32.6?3.3)%] were significantly higher than the ratio in the control group[(21.2?2.3)%,all P0.05).Abdominal infection resulted from CLP also could reduce the content of Bcl-2 protein of thymocytes.The content of Bcl-2 protein of thymocytes in model group(71.2?5.6),non-acupoint group(73.5?5.9)and Zusanli group(82.4?6.8) were significantly lower than normal control group(95.3?6.3,all P

Application of the free vascularized lateral upper arm flap in intraoral reconstruction following ablative tumour surgery / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the application of the lateral arm free flap (LAFF) in the reconstruction for intraoral defects.</p><p><b>METHODS</b>Intraoral reconstruction was performed using the LAFF for 10 patients with oral squamous cell carcinoma of the tongue (n = 3), cheek (n = 4), gingiva (n = 1) and oropharynx (n = 2). There were 8 men and 2 women (mean age, 52 years).</p><p><b>RESULTS</b>Nine LAFF healed uneventfully. One flap was lost on the second postoperative day due to venous insufficiency. The donor defect was closed primarily In all patients. There were no significant complications at the donor site.</p><p><b>CONCLUSIONS</b>Because of the thin and pliable nature, the lateral upper arm flap can be recommended as a choice for repair of moderate-sized defects of the oral maxillofacial area.</p>