The minute ventilation recovery time used as a predictor of weaning in patients with chronic obstructive pulmonary disease / 中华急诊医学杂志

Objective To explore the value of minute ventilation recovery time (VERT) as a weaning predictor in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD).Methods A prospective study was performed from March 2008 to July 2012.Fifty-two COPD patients under mechanical ventilation for more than 48 hours in our RICU tolerated a spontaneous breathing trial (SBT) and were ready for planned extubation.After SBT,these patients were placed back on their pre-SBT ventilator settings for up to 25 minutes,during which VERT was obtained.VERT was defined as the time for minute ventilation to return to baseline measured before SBT.Respiratory rate,tidal volume,minute ventilation and respiratory rate/tidal volume ratio were also obtained before SBT and just after SBT.Arterial blood gas data were measured and recorded before weaning.According to the weaning outcome,the patients were classified as successful group (40 cases) or failed group (12 cases).VERT and other quantitative variables were compared using t test.A multiple logistic regression was performed to explore possible factors associated with the weaning outcome.The sensitivity and specificity of VERT for predictive capacity in weaning were assessed using ROC cure.Results VERT and respiratory rate after SBT were significantly different between two groups.Multiple logistic regression revealed that VERT was the only predictor associated with weaning outcome (b =0.282,P ＜0.001).The area under ROC curve for VERT was 0.957 (95％ CI:O.907-1.008).With a cut-off value of 10.5 minutes,the sensitivity and specificity of VERT for predicting weaning failure were 1.0 and 0.85,respectively.Conclusions VERT may be a new predictor for extubation and determination of mechanical ventilation weaning in patients with COPD.VERT is a variable to be easily measured thereby being conveniently used in clinical practice.

CT findings of central nervous system in congenital syphilis infant / 中华放射学杂志

Objective To investigate the CT features of the central nervous system in congenital syphilis infant. Methods CT findings of central nervous system in 11 infants with clinically proved congenital syphilis were analyzed retrospectively. Results CT findings in 10 syphilis neonates were diffuse hypodense lesions in the white matter, with subarachnoid and intra-encephalic hemorrhage in 3 and 1 cases, respectively. One 2-month-old syphilis infant case and 5 cases of follow-up after 45 days to 6 months of treatment demonstrated bilateral widened sulci and cistern with enlarged ventricles in 3 of them. Conclusion CT findings of the central nervous system in congenital syphilis infant are similar to those of hypoxic-ischemic encephalopathy in neonates, and extra-encephalic hydrocephalus or brain hypogenesis ensues later on.

CT Diagnosis of Testicular Endodermal Sinus Tumor in Childhood / 实用放射学杂志

Objective To study the CT manifestation of testicular endodermal sinus tumor in childhood.Methods Clinical and CT data in sixteen cases of testicular endodermal sinus tumor in children were retrospectively reviewed.Results The tumors appeared as solid masses on plain CT scan,the density of the tumor was homogeneous in 14 cases and heterogeneous in 2 cases.The masses were obviously heterogeneous enhancement after administration of contrast material in 12 cases.Serum ?-fetoprotein(AFP)level was elevated to more than 1000?g/L(normal:less than 20?g/L).Conclusion CT is a valuable in diagnosis of testicular endodermal sinus tumor in children.CT combined with serum AFP can improve the diagnosis of the disease.