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Objective:To explore the early diagnosis and correct treatment of neurogenic pulmonary edema (NPE) and review the literature.Method:Retrospective analysis was performed in six patients diagnosed as NPE who were admitted to the emergency department of Tianjin Third Central Hospital from March 2017 to March 2021.Results:Six patients had acute onset, presenting severe dyspnea and hypoxemia, and obvious wet rales could be heard in both lungs. The white blood cell count (WBC) increased to varying degrees (11-22)×10 9/L, procalcitonin (PCT) was normal, or slightly increased, sputum bacteriological examination was negative, and oxygenation index was < 200 mmHg (1 mmHg≈0.133 kPa). Chest CT mainly showed patchy or patchy exudation. The lesions were of different sizes and were not distributed according to lobes. By reducing intracranial pressure, ventilator assisted breathing, liquid therapy, anti-infection therapy with antibiotics, nutritional support, all six patients were well and discharged, and no one died of NPE. Conclusions:NPE has complex condition, acute onset and rapid development. Early diagnosis and correct treatment can improve the success rate of treatment and prognosis of patients with NPE.
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Objective:To investigate the pathological characteristics in chronic HBV infection patients with different upper limits of alanine aminotransferase (ALT) normal values and the influencing factors of liver tissue injury.Methods:The clinical data of 667 chronic HBV infection patients with ALT<40 U/L and HBV DNA loads >30 IU/mL who received liver biopsy in Zhenhai District Hospital of Traditional Chinese Medicine and Hwa Mei Hospital from January 2014 to December 2020 were retrospectively analyzed. The enrolled patients were divided into ALTⅠ group (<30 U/L for males, <19 U/L for females), ALTⅡ group (≥30 U/L and <35 U/L for males, ≥19 U/L and <25 U/L for females) and ALT Ⅲ group (≥35 U/L and <40 U/L for males, ≥25 U/L and <40 U/L for females). According to the degree of liver inflammation (G) and fibrosis stage (S), the enrolled patients were divided into non-significant damage group (G<2 and S<2) and significant damage group (≥G2 or/and ≥S2). Ridit analysis was used to compare the G/S composition ratio among three ALT groups, Logistic regression was used to analyze the risk factors of liver injury, the receiver operating characteristic curve (ROC) and the area under the curve (AUC) were used to analyze the optimal diagnostic threshold of ALT.Results:There were significant differences in the composition ratio of G and S among the three ALT groups( χ2=13.926 and 14.702, both P<0.001). The constituent ratios of significant liver pathological damage in the three groups of ALT levels were 26.05% (99/380), 32.03% (41/128) and 46.54% (74/159), respectively( χ2=21.596, P<0.001). Multivariate logistic regression analysis showed that high white/globulin ratio and PLT counts( OR=0.246 and 0.986, both P<0.001)were the protective factors for liver tissue injury; while negative HBcAg staining and elevated ALT and GGT levels ( OR=3.797, 1.053 and 1.013, P<0.001 or <0.05) were the risk factors of liver injury. ROC curve demonstrated the ALT threshold of liver tissue damage in male and female patients were 25.6 U/L and 25.5 U/L. Conclusions:In chronic HBV infection patients with normal ALT, with the increase of ALT level, the degree of liver tissue pathological damage may become more severe. The study demonstrates that it is necessary to lower the ALT threshold for protecting patients from liver tissue pathological damage.
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Objective:To establish and evaluate a new diagnostic model for significant liver tissue damage in patients with chronic hepatitis B virus (HBV) infection in the immune tolerance phase.Methods:The clinical data of 275 chronic HBV infection patients in the immune tolerance phase who underwent liver biopsy from January 2015 to November 2020 in the Hwa Mei Hospital, University of Chinese Academy of Sciences were included. According to the liver pathological changes, patients were divided into <G2 group and ≥G2 group, <S2 group and ≥S2 group, non-significant liver pathological damage group (GS0 group, <G2+ <S2) and significant liver pathological damage group (GS1 group, G2 and/or ≥S2). The liver pathological changes and clinical features were analyzed to establish the diagnostic model. The prediction value of the model was compared. Statistical analysis was conducted by linear regression analysis, and the area under the receiver operating characteristic curve, sensitivity and specificity for the diagnostic value of the model were calculated.Results:Among 275 patients, 43 cases (15.64%) had liver histologic activity ≥G2, 30 cases (10.91%) with liver fibrosis ≥S2, and 55 cases (20.00%) with liver damage of GS1. The correlated independent risk factors associated with significant liver pathological damage were age, levels of hepatitis B e antigen, γ-glutamyl transpeptidase, platelet count, alkaline phosphatase and alanine aminotransferase (all P<0.050). The diagnostic model of Y G/S was established according to these factors. The diagnostic efficacy of Y G/Swas highest for patients with liver histologic activity≥G2 and liver pathological damage GS1, with the areas under the curve of 0.783 and 0.811, respectively. The threshold of Y G/S was 0.18, with the sensitivity, specificity and negative predictive value of 0.782, 0.736 and 93.10%, respectively. When Y G/S <0.05, the sensitivity, negative predictive value and negative likelihood ratio were 0.982, 97.96% and 0.08, respectively. When Y G/S≥0.25, the specificity and positive likelihood ratio were 0.905 and 5.14, respectively. When Y G/S≥0.30, the specificity and positive likelihood ratio were 0.959 and 9.33, respectively. Conclusions:Approximately 20.00% of patients with chronic HBV infection in immune tolerance phase have significant liver pathological damage. The diagnostic model of Y G/S (<0.05 or ≥0.30) has certain evaluation value for significant liver pathological damage, and could help these patients avoid liver biopsy to a certain extent.
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Objective:To analyze the liver pathology, clinical characteristics and influence factors in patients with chronic hepatitis B virus (HBV) infection in immune tolerant phase (IT).Methods:The clinical data of 273 patients in IT phase who underwent liver biopsy from January 2015 to December 2019 were included in this study. The correlation between liver pathological changes and clinical features was analyzed.Results:There were 43 cases (15.75%) with liver histologic activity ≥ G2, 30 cases (10.99%) with liver fibrosis ≥ S2, and 55 cases (20.15%) with liver pathology ≥ G2 and/or ≥ S2. A total of 17.95% patients had liver steatosis. The majority (98.17%) of tissue samples were positive for HBsAg staining, while only 79.49% were positive for HBcAg. The characteristics of liver pathology were comparable in men from women patients. The differences of G and S were not statistically significant according to different HBsAg positivity, while those were statistically significant according to different HBcAg positivity. By univariate and multivariate analysis, the independent risk factors of pathological severity were HBcAg intensity, HBeAg level, and age. However, the differences of liver histologic activity and fibrosis were not statistically significant between those younger than 30 years old group from those older than 30 years old, neither between those younger or older than 40. Although the diagnostic value of liver inflammation and fibrosis 5 (LIF-5) was better than that of aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis 4 score (FIB-4), three diagnostic models for predicting the pathological severity were not strong enough (all area under the curves<0.8). Only the specificity of LIF-5 for predicting≥ G2, ≥ G2 and/or ≥ S2 was over 80%.Conclusions:Approximately 20% patients with chronic HBV infection in IT phase have progressive liver inflammation or fibrosis. The intensity of liver HBcAg and HBeAg level are negatively correlated with the severity of disease. The diagnostic models or most clinical indicators have low predictive effect for chronic HBV infections in IT phase.
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The pathogen of COVID-19 is 2019-nCoV, which belongs to the beta coronavirus. Angiotensin-converting enzyme 2 (ACE2) is the receptor of 2019-nCoV as the same of SARS-CoV. Most of the severe patients were the elderly with underlying diseases, which may be related to the decrease in the number of naive T cells. In addition to pulmonary symptoms, COVID-19 can also cause multiple organ dysfunction and even multiple organ failure (liver, nervous system, heart, kidney, etc.). Pathogenic mechanisms such as direct virus invasion, cytokine storm, endothelial cells damage, and down-regulation of ACE2 may play important roles in the severity of the disease.
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The quality of public cardiopulmonary resuscitation training plays an important role in improving the survival rate of patients with cardiac arrest. Various forms of training have been carried out all over China, which plays a great role in promoting the work of cardiopulmonary resuscitation. However, there is still a lot of room for improvement in the quality management and effect sustainability of training. This paper reviews the current situation and deficiencies of quality management of public cardiopulmonary resuscitation training, and the role of training quality in enhancing people's self-confidence in learning and rescue, training contents, training methods, quality evaluation indicators, evaluation methods, and quality influencing factors and retraining time requirements, and so on. And it puts forward some practical suggestions on the quality management of public cardiopulmonary resuscitation training in China. Such as it will more emphasize standardized training, deliberate practice, proficient training, National Training, long-term maintenance of knowledge and skills, and using useful tools to improve the quality of cardiopulmonary resuscitation training, etc. In order to improve the training quality management level of the public, so that the trainees can really master cardiopulmonary resuscitation skills, so as to improve the rescue rate and survival rate of patients with cardiac arrest. To promote the sustainable development of people's health.
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In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the outbreak of COVID-19 in Wuhan. It is a kind of enveloped positive-strand RNA virus, belonging to the subgenus Sarbecovirus of the genus Betacoronavirus. It is similar to other viruses of the subgenus Sarbecovirus in genomic structure and closely related to the bat coronavirus (RaTG13), indicating that its natural host is likely to be bat, but the intermediate host is still controversial. SARS-CoV-2 infects host cells with angiotensin-converting enzyme 2 (ACE2) as a receptor. At present, SARS-CoV-2 has undergone some mutations. This article reviewed the current research situation and progress in the etiology of COVID-19.
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Objective To analyze the heterogeneities of hepatitis B virus ( HBV ) reverse transcriptase domain (RT) gene mutations related to nucleos (t)ide analogues (NAs) resistance.Methods Blood samples from 2765 chronic hepatitis B patients with virological breakthrough or poor drug response treated in Ningbo No .2 Hospital and Ningbo Fourth Hospital from April 2011 to March 2018 were collected . According to the medication status , it was divided into LAM monotherapy group ( n =603 ) , LdT monotherapy group (n=147), ADV monotherapy group (n=68), ETV monotherapy group (n=10) and the sequential or combined drug resistance of NAs group (n=365).The resistance mutation sites and drug resistance patterns (pathways) of each group were analyzed .The SPSS 19.0 software was used to analyze the data.Results Among 2765 serum samples, the NAs-related HBV-RT resistance mutations were detected in 1193 cases with an overall mutation rate of 43.15％.The mutation rate of LAM monoclonal resistance group was 62.62％ (603/963) with 19 mutation types, the most common single point mutation was rtM204I/V (40.30％, 243/603).The mutation rate of LdT monoclonal resistance group was 45.51％(147/323), and there were 3 mutation types, with the single point mutation rtM204I/V being the most common (59.86％, 88/147).The mutation rate of the ADV monoclonal resistance group was 17.80％(68/382), mainly rtA181T single point mutation (64.71％, 44/68).The mutation rate of the ETV monoclonal resistance group was 4.06％(10/246), and the single point mutation of rtT184A/G/S/I/L/F was the most common one (80.00％, 8/10).The mutation rate of the sequential or combination therapy group was 41.91％ (365/871), among which the mutation rate of the LAM/LdT poor response or the resistance with the sequential ADV group was 63.39％(142/224), and the most single mutation point was rtA181V/T ( 35.21％, 50/142 );the mutation rate of LAM/LdT poor response or drug-resistant with combined ADV group was 42.19％ (54/128), and the most common mutation point was rtA181V/T (46.30％, 25/54);the mutation rate of LAM/LdT with poor response or resistance after sequential ETV 1.0 mg was 44.66％(117/262), and the most common mutation point was rtL180M+M204I/V+S202G/I (31.62％, 37/117);the LAM/LdT poor response or the drug-resistant ETV combined with ADV group had a mutation rate of 7.14％(5/70), all of which were multi-site mutations;the mutation rate of poor response to ADV or resistant with sequential ETV 0.5 mg group was 28.14％(47/167), all of which were multi-site mutations.Secondary ( compensation ) sites such as rtV173L, rtL180M, and rtV214A, and single-point mutations such as rtV207I/L/G, rtS213Tand rtN238T, which were not fully defined , were detected.The resistance patterns ( pathways ) of NAs monotherapy were relatively simple , and the resistance patterns ( pathways ) of NAs experienced patients ( sequential or combined treatment group ) were complex and diverse, and multiple resistance patterns (pathways) existed, along with NAs increasing in species.Non-first-line NAs-related resistance patterns ( pathways ) showed an overall downward trend sand ETV-related drug-resistant mutation showed an overall upward trend .Conclusion The NAs-related HBV resistance mutation sites ( patterns ) are complex and diverse , especially multi-site mutations , refractory drug resistance mutations, multidrug resistance mutations and cross-resistance mutations.Therefore, the optimization of antiviral treatment strategies and drug resistance management concepts need to be continuously updated .
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Objective To prepare paraoxonase 1 (PON1) liposomes, and investigate pharmacokinetics of common PON1 liposomes (L-PON1) and polyethylene glycol-modified PON1 long circulating liposomes (PEG-PON1-LCL) in rats after intravenous administration. Methods L-PON1 and PEG-PON1-LCL were prepared by film dispersion method. The entrapment efficiency, mean diameter and Zeta potential of the liposomes were measured, and the stability was evaluated. Thirty-six Wistar rats were divided into three groups according to random number table, with 12 rats in each group. The rats were intravenously administrated with PON1, L-PON1 or PEG-PON1-LCL 700 U/kg, respectively. The activity of PON1 in serum was determined by phenyl acetate method, the activity of PON1 at different time points after drug administration was compared with that before drug administration, and the difference value was considered as the activity of exogenous PON1, and PON1 activity-time curve was plotted. The pharmacokinetic parameters were calculated and analyzed by DAS 2.0 pharmacokinetic program and SPSS 17.0. Results The entrapment efficiencies of L-PON1 and PEG-PON1-LCL were above 85%, the mean diameter was about 126 nm, and Zeta potential was -14.35 mV. After 2 weeks of preservation, the above parameters showed no obvious change, indicating that liposomes had good stability and the properties of preparations were basically stable. Compared with purified PON1 administration, after L-PON1 and PEG-PON1-LCL administration, the activity of PON1 was increased, the half-life of PON1 activity in rats was significantly prolonged [the half-life of distribution (T1/2α, hours): 0.142±0.018, 0.147±0.021 vs. 0.126±0.022; the half-life of clearance (T1/2β, hours): 3.877±1.010, 4.520±1.117 vs. 1.226±0.422], the area under PON1 activity-time curve (AUC) was significantly increased [AUC from 0 hour to 24 hours (AUC0-24, U·h-1·L-1): 499.305±64.710, 563.576±70.450 vs. 18.053±2.190; AUC from the immediate injection to the disappearance of PON1 activity (AUC0-∞, U·h-1·L-1): 516.256±60.940, 587.801±76.210 vs. 21.044±3.250], the apparent volume of distribution (Vd) and clearance (CL) were significantly decreased [Vd (L): 0.140±0.065, 0.144±0.064 vs. 0.493±0.032, CL (L/h):0.039±0.008, 0.034±0.006 vs. 0.952±0.082, all P < 0.05]. There was no significant difference in pharmacokinetics between L-PON1 and PEG-PON1-LCL. Conclusions The film dispersion method prepared PON1 liposomes have high entrapment efficiency and small particle size with a good stability. Both liposomes can raise PON1 activity in vivo, change the pharmacokinetics of PON1 in vivo, prolong the resident time of PON1 in the blood circulating system, and compensate for the short half-life of PON1 in vivo.
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Objective To investigate the intensity of HBsAg and HBcAg expression in liver tissue of patients with chronic hepatitis B virus (HBV) infection and its clinical significance.Methods A total of 994 HBV infected patients underwent liver biopsy and histopathological examination.The expression of HBsAg and HBcAg in liver tissue was detected by histoimmunochemistry.Patients were divided into HBeAg (+)/HBVDNA(+), HBeAg(-)/HBV DNA(+) and HBeAg(-)/HBV DNA(-) groups according to HBeAg and HBV DNA levels;patients were divided into ＜2 × normal (ULN) group, 2-＜5 × ULN groupand ≥5 × ULN group according to the alanine aminotransferase (ALT) levels.The histologic activity (A), fibrosis (F), the expression of HBsAg and HBcAg in liver tissue and their correlations with clinical features were analyzed.Logistic regression analysis was used to study the factors affecting the expression of HBsAg and HBcAg in liver tissue.Results Among 994 HBV infected patients, 941 cases (94.67％) were intrahepatic HBsAg positive and 553 cases (55.63％) were intrahepatic HBcAg positive;403 cases (40.85％) were ≥A2 in histologic activity and 371 cases (36.09％) were ≥F2 in fibrosis.The degree of A and F was the highest in HBeAg (-) / HBV DNA (+) group, followed by HBeAg (-) / HBV DNA (-) group, and was the lowest in HBeAg (+) / HBV DNA (+) group.The intensity of intrahepatic HBsAg expression was significantly different among three groups (x2 =6.299, r =-0.760, P ＜ 0.05), however, the difference was not showed in pairwise comparisons.The difference of intrahepatic HBcAg intensity among three groups was statistically significant (x2 =282.995, r =-0.645, P ＜ 0.01), the intensity was the highest in HBeAg (+) / HBV DNA (+) group and the lowest in HBeAg (-) / HBV DNA (-) group.The constituent ratio of HBeAg positive and HBV DNA level were higher and the average age was lower in intrahepatic HBsAg positive group than those in HBsAg negative group.The constituent ratio of positive HBeAg, the levels of ALT, AST, PLT and HBV DNA were higher and the average age, the average FIB-4 level were lower in intrahepatic HBcAg positive group than those in HBcAg negative group.The HBV DNA level was an independent risk factor for intrahepatic HBsAg intensity, and the HBeAg positive and HBV DNA level were independent risk factors for intrahepatic HBcAg intensity.There were no significant differences in A and F among different groups of intrahepatic HBsAg intensity (x2 =1.943 and 2.630, both P ＞ 0.05).There was significant difference in F among different groups of intrahepatic HBcAg intensity (x2 =12.352, P ＜ 0.01), but not in A.The degree of F was the highest in intrahepatic HBcAg negative group.There was significant difference in intrahepatic HBcAg intensity among different groups of ALT level (x2 =16.349, P ＜ 0.01), but not in intrahepatic HBsAg intensity.The intrahepatic HBcAg intensity in ALT ＜ 2 × ULN group was lower than that in other two groups.Conclusions Most of patients with chronic HBV infection are intrahepatic HBsAg positive and more than half of them are intrahepatic HBcAg positive.The intrahepatic HBsAg intensity is not associated with A and F, but correlates with HBV DNA level.The intrahepatic HBcAg intensity is not associated with A, but it is negatively correlated with F and positively correlated with positive HBeAg expression, HBV DNA level and ALT level.
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Objective To analyze the correlation between liver pathology and clinical characteristics in a large series of patients with chronic HBV infections , so as to provide the data base for non-invasive medical diagnosis .Methods Liver pathology and clinical characteristics of 1 397 patients with chronic HBV infections were retrospectively analyzed . Ridit analysis and Spearman correlation analysis were performed to investigate the correlations of clinical characteristics with liver pathology of patients .Results In 1 397 patients, there were 604 patients (43.24%) with liver inflammation grading ≥G2 and 504 patients (36.08%) with fibrosis stage ≥S2.Inflammation grade and fibrosis stage of liver tissues were both higher in male patients than those in females (u=3.093 and 2.854, P30-40 years and >40 years (r=0.259 and 0.303, P0.05),but there was significant difference in liver fibrosis in patients between aged >40 years and ≤30 years ( F=3.177,P30 years, lightly elevated ALT levels , HBeAg(-) and detectable HBV DNA levels , especially in male patients .Screening for liver fibrosis should be considered in patients with HBeAg ( -) and low HBV DNA levels .
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Objective To assess the liver biopsy and the clinical characteristics of inactive HBsAg carriers.Methods One hundred and ten inactive HBsAg carriers,including 76 males and 34 females aged (38.9 ± 9.4) years (21-66),underwent liver biopsy from January 2011 to September 2015,the histopathological findings and clinical features were analyzed.Among 110 cases the inflammation activity (A) was ＜ A2 in 73 cases and ≥A2 in 37 cases;the fibrosis (F) ＜ F2 in 63 cases and ≥F2 in 47 cases.The upper limits of normal (ULN) for ALT was defined as 30 U/L for men and 19 U/L for women according to World Health Organization (WHO) standard,and 50 U/L for men and 40 U/L for women according to Chinese national standard.There were 59 cases with ALT ＜ 1 × ULN of WHO standard and 110 cases with ALT ＜ 1 × ULN of Chinese standard.Results In 110 inactive HBsAg carriers,there were 100 cases (90.9％) ≥A1 and 37 cases (33.6％) ≥A2,84 cases (76.3％) ≥F1 and 47 cases (42.7％) ≥F2.The severity of A and F were both higher in males than that in females,especially that of F (U =2.162,P =0.032;x2 =5.315,P =0.021).But there were no statistical differences between WHO standard group and Chinese standard group (U =0.951,0.435;P =0.341,0.663).Along with the increase of age,the degrees of A and F aggravated (F =3.705,5.915;P =0.014,0.001).The average ages in ≥ A2 group and ≥F2 group were (41.7 ± 9.6) years and (38.7 ± 8.1) years,respectively.The independent risk factors for severity of A and F were age,gender (male) and age,respectively.Conclusion There may be histological damages of varying degree in liver tissues of most inactive HBsAg carriers,and for those aged 40 years and over,especially males screening of liver histological activity and fibrosis would be necessary.
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Objective To effectually record cardiopulmonary resuscitation (CPR) procedure, analyze and compare the CPR performance of all medical and nursing staffs to find out the existed information for the improvement of the quality of CPR and its survival rate. Methods The medical data were collected according to the Utstein Criteria and CPR event was automatically recorded by a digital video-recording system, by which hands-off times within 10 minutes of CPR and times for installation of chest compression machine, establishment of endotracheal intubation and establishment of the venous channel were analyzed. Multiple regression analysis was conducted to analyze the factors affecting CPR effect. Results ① During the period from December 2009 to December 2015, a total of 376 patients with cardiac arrest (CA) was registered, including 248 males and 128 females, with a median age of 68 (53, 78) years. Estimated median time interval from CA to CPR initiation was 5.0 (0.1, 20.0) minutes and there were 189 cases less than or equal to 5 minutes. The acute myocardial infarction (AMI) with 145 cases (38.6%) was the main etiology of CA. Initial shockable rhythm was found in 16 patients (7.0%) out of 230 out-of-hospital cardiac arrest (OHCA) patients, of whom 13 underwent ventricular fibrillation (5.7%), 3 underwent ventricular tachycardia (1.3%). Initial shockable rhythm was found in 47 patients (32.2%) out of 146 in-hospital cardiac arrest (IHCA) patients, of whom 40 underwent ventricular fibrillation (27.4%), and 7 underwent ventricular tachycardia (4.8%). CPR by a mechanical device (Thumper) was performed in 219 patients (58.2%). In 376 patients, 186 patients had return of spontaneous circulation (ROSC, 49.5%), a successful CPR (ROSC ≥ 24 hours) was found in 110 patients (29.3%), 99 patients was hospitalized alive (26.3%) and 40 patients were discharged alive (10.6%). In 146 cases of IHCA, 89 patients had ROSC (61.0%), a successful CPR was found in 63 patients (43.2%), 56 patients were hospitalized alive (38.4%), and 29 patients were discharged alive (19.9%). In 230 patients of OHCA, 89 patients had ROSC (38.7%), 65 patients received pre-hospital CPR (28.3%), a successful CPR was found in 47 patients (20.4%), 43 patients were hospitalized alive (18.7%), and 11 patients were discharged alive (4.8%). There were 37 patients had a successful CPR (69.8%), and 25 patients were discharged alive (47.2%) in 53 patients with ventricular fibrillation. ② There were 77 patients with valid video information for analysis of CPR performance, with 48 patients of OHCA, and 29 patients of IHCA. Delay median time from the patients presence in the resuscitation room to be placed in rescue bed was 22 (0, 33) seconds. Hands-off median times during 10 minutes of CPR was 41 (18, 90) seconds. Thumper installment median times was 43 (31, 69) seconds. Median time for endotracheal intubation was 59 (35, 109) seconds. Median time of venous catheter placement was 112 (70, 165) seconds. It was shown by multivariate regression analysis that there was a significant correlation between estimated time interval from CA to CPR performed, hands-off time and success rate of CPR (t1 = -3.452, t2 = -2.729), rate of discharge alive (t1 = -2.328, t2 = -2.736, all P < 0.05). In 48 OHCA patients, success rate of CPR was significantly correlated with estimated time interval from collapse to CPR performed (t = -2.409, P = 0.021). In 29 IHCA patients, success rate of CPR and rate of discharge alive was significantly correlated with hands-off times (t1 = -3.412, t2 = -2.536, both P < 0.05). Conclusions Survival to hospital discharge following CA is significantly correlated with the time interval from collapse to CPR performed and hands-off times in CPR. Installment and usage of Thumper should be postponed in order to reduce hands-off times during CPR in IHCA.
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Objective To comparatively analyze the immunological characteristics of patients with mild and severe influenza A (H1N1), and to provide the evidence for condition monitoring and treatment . Methods 52 cases with mild influenza A ( H1N1), 152 cases with severe influenza A ( H1N1) and 26 healthy subjects from July 1, 2009 to December 31, 2009 were enrolled in the study.Lymphocyte subsets in peripheral blood were analyzed by flow cytometry and the serum concentrations of interferon -γ( IFN-γ) and interleukin-4 (IL-4) were detected by enzyme-linked immune-sorbent assay (ELISA).Results The total lymphocyte counts were decreased obviously in patients with severe influenza A ( H1N1) than in mild pa-tients and in healthy subjects (P0.05).Con-clusion Immune dysfunction in patients with influenza A (H1N1) infection is associated with the severity of disease, especially cellular immunity .Therefore, monitoring of the immune system is valuable for the diag-nosis of influenza A(H1N1) infection.
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Objective To explore the clinical feature diagnosis and therapy of 16 patients with HBV liver cirrhosis concomitant with acute pancreatitis. Methods Retrospective analysis of the clinical data including symptoms and signs, laboratory findings, therapy, progress of the illness and prognosis. Results All patients had abdominal pain and tenderness pain to some degree, changes of pancreas ultrasonogram and CT were found in all patients. Nausea and vomiting, radiating pain, muscle guarding, fever and high level of serum amylase and white blood cells were seldom found. The ratio of neutrocyte and white blood cells was high in all patients. All patients adopted surgical therapy died. Pancreatitis often relapsed and damage of liver was severe. Conclusions The clinical manifestations of liver cirrhosis concomitant with acute pancreatitis are atypical. It is necessary to combine with the symptoms, signs and labotatory finds for making a right diagnosis and employing the non-surgical treatment. Patients with that illness have poor progress and prognosis.