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Hepatic fibrosis (HF) is a key stage in the progression of chronic hepatitis to liver cirrhosis and even liver cancer, and it is a dynamic and reversible pathological change. Studies have shown that integrated traditional Chinese and Western medicine therapy has a good therapeutic effect on HF and can delay or reverse the progression of this disease. This article summarizes the pathogenesis of HF and discusses the diagnosis of HF, traditional Chinese medicine and Western medicine therapies, and the path of integrated traditional Chinese and Western medicine therapy, so as to provide ideas for the basic research and clinical application of integrated traditional Chinese and western medicine in the prevention and treatment of HF.
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One hundred Alzheimer′s disease (AD) patients with behavioral and psychological symptoms of dementia (BPSD) treated with donepezil+risperidone group ( n=50, group 1) or hydrochloride memantine+risperidone group ( n=50, group 2) in geriatric departments of Hangzhou Seventh People′s Hospital were enrolled in the study. Montreal cognitive assessment scale (MoCA), positive and negative syndrome scale (PANSS), treatment emergent symptom scale (TESS) were applied for evaluation; and blood routine examination, blood biochemistry, eletrocardiogram were performed in two groups before and after treatment. After treatment, MoCA score in group 2 (16.10±3.90) was significantly higher than that in group 1 (18.14±3.71)( t=-3.99, P<0.01), and PANSS score in group 2 (86.66±6.62) was significantly lower than that in group 1 (109.50±11.51; t=12.67, P<0.01). The incidence rates of dry mouth (16%,8/50), extrapyramidal side effects (10%,5/50) and the total score of TESS (3.92±2.02) in group 2 were markedly lower than those of group 1 [44%(22/50), 36%(18/50), (12.49±1.45);χ 2=9.33,9.54, t=17.90,all P<0.01]. Meanwhile, group 2 had significantly lower influences on the levels of blood lipids and fasting blood glucose (all P<0.01). The risperidone dose used in group 2 was significantly lower than that in group 1 [(2.06±0.50) vs. (3.85±0.89)mg, t=14.40, P=0.04].The results suggest that hydrochloridememantine combined with risperidone is more effective with less side effects compared to donepezil combined with risperidone for AD patients with BPSD.
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Hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome is a rare hereditary disease and characterized by cutaneous leiomyoma, uterine leiomyoma and/or renal cell carcinoma, but rarely associated with vena cava embolism. We treated 1 case of HLRCC syndrome patients with inferior vena cava tumor emboli (Mayo grade Ⅳ), confirmed after genetic testing, the patient and her family refused further treatment. The patient died after two months of follow-up after discharge.
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Objective:To evaluate the precision of quantitative CT (QCT) in measuring fat content of goose liver and to explore the influence of tube voltage on liver fat measurement.Methods:From January to March 2017, 22 Landes geese were selected to establish fatty liver models with overfeeding. The QCT was performed under 2 different tube voltages, 80 and 120 kV. In addition to the voltage, the other scanning parameters were the same. Three ROI were placed in the centre part of the left lobe, upper and lower half of the right lobe on the 3D reconstructed images. The volume percentage of goose liver fat (Fat% QCT) was calculated according to the formula provided by Mindways. Immediately after the QCT examinations, each goose was dissected, and the whole liver was removed. Then samples were taken in the corresponding areas of the ROI by QCT. The fat (triglyceride) content of the samples was measured by the biochemical extraction method. The Spearman correlation tests were used to determine the correlation between the QCT measurements of 80 kV and 120 kV groups and the results of biochemical extraction method. The Wilcoxon signed-rank test was performed to compare Fat% QCT between 80 kV and 120 kV groups. Bland-Altman plots were used to assess agreement between the two groups′ measurements. Results:The Fat% QCT of both 80 kV and 120 kV group positively correlated highly with biochemical extraction ( r s=0.936, P<0.001, r s=0.927, P<0.001) respectively. No statistically significant difference of Fat% QCT was detected between 80 kV and 120 kV group ( Z=-0.141, P=0.888). Bland-Altman analysis showed a small difference of Fat% QCT between the 80 kV and 120 kV group, in which mean values were 0.20%. Conclusions:Using biochemical extracted triglyceride as the reference, under the conditions of low-dose 80 kV and standard 120 kV tube voltages, QCT measurement of fat content is accurate and reliable in goose liver.
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Objective:To explore the effect of Yifei-Huoxue Decoction combined with conventional western medicine on patients with oxidant-antioxidant imbalance with COPD. Methods:A total of 102 patients who met the inclusion criteria from January 2016 to December 2018 were divided into two groups, according to the random table method, 51 cases in each group. The control group was treated with conventional western medicine, while the research group was treated with Yifei-Huoxue Decoction based on control group. Both the two groups were treated for 14 days. The traditional Chinese medicine symptom scores of the two groups were compared before and after the treatment. The forced expiratory volume in one second/predicted value ratio (FEV1%pred) was measured by pulmonary function instrument, FEV1/forced vital capacity (FVC) was calculated. Partial pressure of oxygen (PaO 2) and partial pressure of carbon dioxide (PaCO 2) were measured by blood gas analyzer. The levels of MDA, SOD and Glutathioneperoxidase (GSH-Px) were detected by ELISA, and the clinical effect was evaluated. Results:The total effective rate of research group was 98.0% (50/51), the control group was 80.4% (41/51), and the difference between the two groups was statistically significant ( χ2=8.254, P=0.004). After the treatment, the scores of cough, expectoration, asthma, panic, chest distress and fatigue in the research group were significantly lower than those of the control group ( t values were 3.716, 6.524, 5.032, 2.516, 4.804 and 2.882, respectively, all Ps<0.05). After the treatment, the FEV1%pred (68.05% ± 6.11% vs. 59.02% ± 5.45%, t=7.876), FEV1/FVC (60.10 ± 5.83 vs. 54.05 ± 5.07, t=5.592), PaO 2 (67.79 ± 3.82 mmHg vs. 60.63 ± 3.55 mmHg, t=9.805) in the research group were significantly higher than those of the control group ( P<0.05), the PaCO 2 (56.08 ± 2.25 mmHg vs. 61.14 ± 2.13 mmHg, t=11.663) was significantly lower than that of the control group ( P<0.01), the levels of serum MDA (3.21 ± 0.63 μmol/L vs. 4.95 ± 0.87 μmol/L, t=11.568) was significantly lower than that of the control group ( P<0.01), the levels of SOD (73.35 ± 8.97 μU/ml vs. 61.68 ± 7.82 μU/ml, t=7.003), GSH-Px (170.35 ± 17.72 U/ml vs. 149.14 ± 15.04 U/ml, t=6.517) were significantly higher than those of the control group ( P<0.01). Conclusions:The Yifei-Huoxue Decoction combined with conventional western medicine could improve the lung function of children with COPD , adjust the imbalance condition of oxidation/antioxidation, so as to improve the clinical effect.
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Metastatic seminal vesicle carcinoma is rare in clinic. The case of renal clear cell carcinoma metastasis to the seminal vesicle gland is more rare, which is difficult to be identified with bladder, prostate and colorectal tumors. In November 2017, 1 case of renal clear cell carcinoma metastasis to the left side of the seminal vesicle gland was admitted in our hospital.Laparoscopy seminal vesicle metastasis tumor resection was performed. Regular bladder irrigation and sunitib oral intake were conducted. No evidence of local recurrence was found within 19 months follow-up.
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Metastatic seminal vesicle carcinoma is rare in clinic.The case of renal clear cell carcinoma metastasis to the seminal vesicle gland is more rare,which is difficult to be identified with bladder,prostate and colorectal tumors.In November 2017,1 case of renal clear cell carcinoma metastasis to the left side of the seminal vesicle gland was admitted in our hospital.Laparoscopy seminal vesicle metastasis tumor resection was performed.Regular bladder irrigation and sunitib oral intake were conducted.No evidence of local recurrence was found within 19 months follow-up.
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Objective@#To study the effect of doxofylline on acute exacerbation of chronic obstructive pulmonary disease (COPD) and reduce the risk of early recurrence.@*Methods@#From January 2016 to January 2018, 164 patients with acute exacerbation of COPD in Binzhou Central Hospital were randomly divided into two groups by random digital table: control group (n=82) and observation group (n=82). The control group was given tiotropium bromide and budesonide/formoterol.The observation group was treated with oral doxophylline bid for 8 weeks on the basis of inhaled drugs.The recovery time, acute exacerbation rate, FEV1, CAT score and 6-minute walking test were compared between the two groups.@*Results@#The time of convalescent stage in the observation group was shorter than that in the control group[(16.89±5.15)d vs.(19.12±6.29)d, t=2.48, P=0.014], and the acute exacerbation rate of the observation group was lower than that of the control group (26.83% vs.41.46%, χ2=4.58, P=0.032). There was no statistically significant difference in FEV1[(45.59±9.82)% vs.(44.26±9.03)%, t=0.90, P=0.369], and the CAT score of the observation group was better than that of the control group [(19.32±6.16)points vs.(21.71±6.62)points, t=2.39, P=0.018]. The 6-minute walking distance of the observation group was longer than that of the control group[(146.32±10.20)m vs.(135.69±11.59)m, t=6.23, P=0.000], and the finger pulse oxygen of the observation group was higher than that of the control group[(94.12±5.09)% vs.(92.06±6.21)%, t=2.23, P=0.026]. The respiratory rate in the observation group was slower than that in the control group[(20.38±7.32)times/min vs.(22.86±6.53)times/min, t=2.29, P=0.023], and there was no statistically significant difference in heart rate[(98.24±12.35)bpm vs.(101.38±15.03)bpm, t=1.46, P=0.146]. No serious adverse drug reactions were found in both two groups.@*Conclusion@#As a beneficial supplement of inhaled drugs in convalescent COPD, doxofylline can shorten the recovery time, reduce the early acute exacerbation rate and improve the symptoms, which is worthy of clinical reference.
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Objective To observe the effect of modified electroconvulsive therapy (MECT) on au-tobiographical memory and efficacy in schizophrenic patients. Methods Seventy-four patients with schizo-phrenia were randomly divided into study group (38 cases) and control group (36 cases). The study group was treated with MECT for 10-12 times in combination with single antipsychotic drug,while the control group was treated with single antipsychotic drug. Both groups were treated for 12 weeks. All patients were assessed for autobiographical memory before treatment and at the 4th,8th and 12th week after treatment,and the effi-cacy was evaluated by the positive and negative symptom scale (PANSS). Results (1)The response time of autobiographical event memory in the study group at the 4th and 8th weekends after treatment ((2 058. 84 ±200. 06)ms,(1 883. 61±202. 17)ms)were significantly longer those at baseline((1 765. 27±203. 23)ms) and that at the same periods in the control group(( 1 787. 03 ± 192. 82),(1 762. 01± 195. 25)),and the differences were statistically significant(t=6. 346,2. 545;P<0. 05,t=5. 945,2. 630;P<0. 05),but the re-sponse time of autobiographical event memory in the study group at the 12th weekend after treatment was not statistically significant compared with that before treatment (P>0. 05). ( 2) For each time point after treat-ment,the PANSS scores of the study group and the control group were significantly lower than those at base-line (P<0. 05). The PANSS scores of the study group at each time point after treatment((62. 42±7. 22), (49. 32±5. 54),(43. 63±9. 90)) were significantly lower than those of the control group at the same periods ((71. 78±10. 19),(56. 14±5. 95),(49. 28±9. 31)),and the differences were statistically significant ( t=4. 577,5. 108,2. 525;all P<0. 05). The total effective rate of the study group ( 94. 7%) was significantly higher than that of the control group (80. 6%) (χ2=9. 287,P<0. 05). Conclusions MECT is effective in the treatment of patients with schizophrenia,and it has some damage to their autobiographical memory,but the damage is transient and reversible.
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Objective To evaluate the diagnostic value of magnetic resonance spectroscopy analysis in patients with prostate specific antigen (PSA) abnormal prostate disease. Methods The patients who had abnormal PSA from January 2017 to December 2018 in Weifang People′s Hospital were selected. Patients with prostate puncture indications were as research target. A total of 137 patients including 44 patients with prostate cancer and 93 patients with benign prostatic hyperplasia were diagnosed by puncture. All patients underwent magnetic resonance scan and enhancement and spectroscopy before surgery. The comparative value of magnetic resonance scan + enhancement, magnetic resonance spectroscopy and joint examination was obtained. Results Sensitivity of magnetic resonance imaging and enhancement was 77.3% (34/44), specificity was 86.0% (80/93), and accuracy was 83.2% (114/137). Sensitivity of magnetic resonance spectroscopy was 52.3% (23/44), specificity was 77.4% (72/93), and accuracy was 69.3% (95/137). The sensitivity of the combined application was 90.9% (40/44), specificity was 91.4% (85/93), and accuracy was 91.2% (125/137). Conclusions The application of magnetic resonance spectroscopy can increase the sensitivity, specificity and accuracy of magnetic resonance plain scan and intensive examination for diagnosis of prostate cancer.
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Objective To evaluate the safety and efficacy of botulinum toxin type A for injection in the treatment of post-stroke upper limb spasticity (dosage was 200 U,or 240 U if combined with thumb spasticity).Methods The study was a multi-center,stratified block randomized,double-blind,placebocontrolled trial.All the qualificd subjects were from 15 clinical centers from September 2014 to February 2016.They were randomized (2∶1) to injections of botulinum toxin type A made in China (200-240 U;n =118) or placebo (n =60) in pivotal phase after informed consent signed.The study was divided into two stages.The pivotal trial phase included a one-week screening,12-week double-blind treatment,followed by an expanded phase which included six-week open-label treatment.The tone of the wrist,finger,thumb flexors was assessed at baseline and at weeks 0,1,4,6,8,12,16 and 18 using Modified Ashworth Scale (MAS),disability in activities of daily living was rated using the Disability Assessment Scale and impaction on pain,muscle tone and deformity was assessed using the Global Assessment Scale.The primary endpoint was the score difference between botulinum toxin type A and placebo groups in the tone of the wrist flexor using MAS at six weeks compared to baseline.Results Muscle tone MAS score in the wrist flexor of botulinum toxin type A and placebo groups at six weeks changed-1.00 (-2.00,-1.00) and 0.00 (-0.50,0.00) respectively from baseline.Botulinum toxin type A was significantly superior to placebo for the primary endpoint (Z =6.618,P ＜ 0.01).The safety measurement showed 10 subjects who received botulinum toxin type A had 13 adverse reactions,with an incidence of 8.47％ (10/118),and three subjects who received placebo had three adverse reactions,with an incidence of 5.00％ (3/60) during the pivotal trial phase.All adverse reactions were mild to moderate,none serious.There was no significant difference in adverse reactions incidence between the botulinum toxin type A and the placebo groups.During the expanded phase three subjects had four adverse reactions and the incidence was 1.95％.All adverse reactions were mild,none serious.Conclusion Botulinum toxin type A was found to be safe and efficacious for the treatment of post-stroke upper limb spasticity.Clinical Trial Registration:China Drug Trials,CTR20131191
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Objective To test the protective effect of a new Ringer's malate solution on intestine's apoptosis caused by hemorrhagic shock in rats.Methods Forty-eight Sprague-Dawley male rats, weighing 280-320 g, were randomly assigned into four groups: sham shock group (group SS), normal saline group (group NS), Ringer's lactate group (group RL) and Ringer's malate (group RM), n=12 each.The group SS was served as control group, the other groups were subjected to 60 min of hemorrhagic shock followed by crystalloid resuscitation.Those rats were sacrificed 3 h after resuscitation.Intestinal tissue was harvested to detect Bcl-2/Bax protein level, the bioactivity of superoxide dismutase (SOD) and malondialdehyde (MDA) level.The level of intestinal cell apotosis was measured using TUNEL method and apoptosis index was calculated.The intestinal histopathology was examined.Results Compared with group SS, the expression of Bcl-2 and the bioactivity of SOD were lower, the level of Bax protein, MDA and apoptotic index were higher in groups NS, RL and RM (P<0.05).Compared with groups NS and RL, the expression of Bcl-2 and the bioactivity of SOD was higher, the level of Bax protein, MDA and apoptotic index were lower in group RM (P<0.05).Histopathological examination showed that group RM was better than group NS and group RL.Conclusion Ringer's malate alleviated intestinal apoptosis caused by hemorrhagic shock in rats.The study suggests that Ringer's malate solution could be a potential new therapeutic agent for fluid resuscitation.
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Objective To evaluate whether changes in neonatal intensive care have improved outcomes for extremely low birth weight (ELBW) infants in neonatal intensive care unit (NICU). Methods A prospective phase-lag cohort study was performed in a tertiary level NICU. A meticulous nursing strategy based on neonatal individual developmental care assessment program theory and feasible ELBW minimization stimulus was developed. Conventional care was applied in 2013 (period Ⅰ) and gently caring was applied in 2014 (period Ⅱ). The outcomes of ELBW between these 2 periods were compared. Results During these two periods, thirty-seven infants were included in period Ⅰ and 41 infants in period Ⅱ. In periodⅠ46.0%(17/37) of the infants needed oxygen for at least 28 days, but in period Ⅱ it decreased to 24.4%(10/41), there was significant difference (χ2=3.990, P=0.046). The rate of breastfeeding increased from 27.0%(10/37) in periodⅠto 61.0%(25/41) in period Ⅱ, there was significant difference (χ2=9.061, P=0.003). There was no significant difference in the mortality rate and chronic lung disease (P>0.05). The incidence of intracranial hemorrhage decreased from 21.6%(8/37) to 4.9%(2/41), there was significant difference(P=0.041). Conclusions Gently caring may have resulted in less intracranial hemorrhage and improve breastfeeding rate. Parents are satisfied with gentle care and in light of these findings, gentle care deserves further exploration.
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Objective@#To investigate the clinicopathological features of mammary analogue secretory carcinoma (MASC) of salivary glands, and its diagnosis, differential diagnosis, immunohistochemistry and molecular pathology.@*Methods@#Seventeen cases of MASC were enrolled, with 9 cases of salivary acinar cell carcinoma and 18 cases of adenoid cystic carcinoma as control groups from Nanjing General Hospital from 1997 to 2014 were included in this retrospective study, combined with immunohistochemistry and molecular detection of ETV6-NTRK3 gene fusion. All cases were histologically reviewed with immunohistochemical staining (EnVision) for S-100 protein, SOX10, GATA3, CD117 expression in each group. Fluorescence in situ hybridization (FISH) was used to detect the ETV6-NTRK3 gene fusion.@*Results@#The age of MASC patients ranged from 27 to 74 years with mean age of 47 and ratio of male and female was 4∶3. All cases showed infiltrative growth and diverse cytology and histology, including lobular (8 cases), cystic papillary (3 cases), cribriform mixed with papillary and glandular structures (6 cases) at various proportions. Some tumors of MASC also exhibited solid growth areas with occasional microcystic honeycombed pattern composed of small cysts merged into larger cysts resembling thyroid follicles. S-100 protein and SOX10 were strongly positive in all MASC cases (17/17). In addition, there was insignificant positivity for GATA3 (3/17) and CD117 (4/17). ETV6 gene fusion detection was informative in 12 MASC cases by FISH with 10 positive cases and 2 negative cases.@*Conclusions@#Combined immunohistochemical positivity of S-100 protein, CD117 and SOX10 are useful in the diagnosis and differential diagnosis of MASC. FISH detection of ETV6-NTRK3 fusion offers an additional molecular diagnostic marker for the diagnosis.
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Objective To compare the degree of liver injury during resuscitation with different crystalloid solutions in a rat model of hemorrhagic shock.Methods Forty-eight SPF healthy male SpragueDawley rats,aged 7-9 weeks,weighing 280-320 g,were assigned into 4 groups (n=12 each) using a random number table:sham operation group (group S),normal saline group (group NS),Ringer's lactate solution group (group RL) and Ringer's malate solution group (group RM).Hemorrhagic shock was induced by withdrawing blood from the right internal jugular vein until mean arterial pressure was reduced to 35-45 mmHg which was maintained for 1 h.The internal jugular vein and artery were cannulated after anesthetization,but no animals were subjected to hemorrhage in group S.The crystalloid solution (2 times the volume of blood loss) was infused intravenously over 30 min starting from 1 h of shock.The animals were resuscitated with 0.9％ sodium chloride solution in group NS,with Ringer's lactate solution in group RL,and with Ringer's malate solution in group RM.Mean arterial pressure was continuously monitored and recorded during the experiment.Before shock (T1),at 1 h of shock (T2) and at 4 h after resuscitation (T3),blood samples were collected from the right internal jugular vein for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations by enzyme-linked immunosorbent assay.Rats were sacrificed at T3,and livers were removed for measurement of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in liver tissues (using colorimetric method) and for examination of pathological changes of liver tissues (with light microscope).Results Compared with group S,the serum ALT and AST concentrations at T2.3 and SOD activity and MDA content at T3 were significantly increased in NS,RL and RM groups (P＜0.05).Compared with group NS or group RL,the serum ALT and AST concentrations were significantly decreased,the SOD activity was increased,and the MDA content was decreased at T3 (P＜0.05),and the pathological changes of liver tissues were significantly attenuated in group RM.Conclusion Ringer's malate solution produces better efficacy than normal saline and Ringer's lactate solution when used for resuscitation and mitigating liver injury in a rat model of hemorrhagic shock.
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Objective To study the effects of two types of crystalloids on postoperative inflam-matory reaction during the process of cesarean section.Methods Sixty patients undergoing cesarean section were randomly divided into Ringer lactate solution group (RL)and Ringer acetate solution group (RA)with 30 cases in each group.Before anesthesia,10 ml/kg crystal solution was infused, the infusion rate was 1 5-20 ml·kg-1 ·h-1 .The patients were performed epidural anesthesia in left lateral position.Crystal solution was infused to maintain the blood pressure during the operation.Ve-nous blood was drawn at the beginning of the operation (T1 ),the end of the operation (T2 ),four hours after operation (T3 ),twenty-four hours after operation (T4 )in order to measure the blood plasma value of IL-6,TNF-α,CRP.Results The blood plasma value of IL-6,TNF-α,CRP had no significant differences at T1 ,T4 ;but the value of group RA was significantly higher than that of group RL (P <0.05)at T2 ,T3 .Conclusion Ringer acetate solution causes more significant postop-erative inflammatory cytokine release than Ringer lactate solution does during the process of cesarean section.
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Objective To investigate the effects of different doses of dexmedetomidine combined with propofol and remifentanil target controlled infusion (TCI) on postanesthesia recovery of patients in functional endoscopic sinus surgery. Methods Eighty ASA Ⅰor Ⅱ grade patients, scheduled for the endoscopic sinus surgery, were divided into control group (20 cases) and dexmedetomidine group (60 cases) according to the random digits table method. The patients in dexmedetomidine group were given loading dose dexmedetomidine 0.6 μg/kg, then were given dexmedetomidine of different maintenance doses:0.3 μg/(kg·h) in D1 group, 0.6 μg/(kg·h) in D2 group and 0.9 μg/(kg·h) in D3 group. The patients in dexmedetomidine group were given TCI propofol and remifentanil during the maintenance of general anesthesia, rocuronium was administrated intermittently during operation, and bispectral index (BIS) was controlled at 40 - 50. The changes of hemodynamics 5 - 10 min after entering operation room (T0), before induction (T1), 1 min after intubation (T2), 5 min after intubation (T3), before extubation (T4) and 5 min after extubation (T5) were observed. The spontaneous breathing recovery time, call of eye-opening time, extubation time and adverse reaction after surgery were recorded. Moreover, the visual analogue score (VAS) and Ramsay sedation score were used to evaluate the comfort level of patients. Results The mean arterial pressure (MAP) at T5 in control group and D1 group were significantly higher that in D2 group and D3 group, and there were statistical differences (P0.05). The VAS 15 min after extubation in D1 - D3 group were significantly lower than that in control group: (3.7 ± 0.3), (3.1 ± 0.4) and (3.0 ± 0.5) scores vs. (6.2 ± 0.6) scores, and there were statistical differences (P<0.05). The Ramsay sedation scores in D1 - D3 group were significantly higher than that in control group:(2.5 ± 0.2), (2.7 ±0.2) and (5.3 ± 0.3) scores vs. (1.4 ± 0.3) scores. Moreover, Ramsay sedation score in D3 group was significantly higher than that in D1 group and D2 group, and Ramsay sedation score in D2 group was significantly higher than that in D1 group. There were statistical differences (P<0.05). Four and 2 patients occurred nausea vomiting respectively in control group and D1 group within 24 h after operation. Conclusions Dexmedetomidine combined with propofol and remifentanil TCI can maintain hemodynamic stability and improve anesthesia recovery quality.
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Objective To study the success rate of ventilator weaning in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients influenced by bobbed endotracheal intubation. Methods One hundred and sixteen AECOPD patients who were given invasive mechanical ventilation and reached the standards of off-ventilator were divided into control group (general endotracheal intubation group) and experiment group bobbed (tracheal intubation) by random digits table method with 58 cases each. The respiratory rate (RR), heart rate (HR), rapid and shallow breathing index (RSBI), oxygenation index (OI), pulse blood oxygen saturation (SpO2), tidal volume and success rate of ventilator weaning were compared. Both groups were implemented of extubation if they reached the standards of the extubation time by observing their ability in spontaneous breathing test (SBT). Results The RR, HR and RSBI before extubation in experiment group were significantly lower than those in control group:(19.7 ± 2.3) times/min vs. (23.5 ± 2.3) times/min, (91.2 ± 6.3) times/min vs. (93.4 ± 8.1) times/min and 80.2 ± 6.7 vs. 90.5 ± 9.6, P<0.05, and the OI, SpO2, tidal volume and success rate of ventilator weaning were significantly higher than those in control group: (269 ± 9) mmHg (1 mmHg = 0.133 kPa) vs. (245 ± 16) mmHg, 0.929 ± 0.014 vs. 0.870 ± 0.037, (6.1 ± 1.2) ml/kg vs. (5.1 ± 0.8) ml/kg and 91.38%(53/58) vs. 77.59%(45/58), P<0.05. Conclusions The bobbed endotracheal intubations can improve the success rate of ventilator weaning in patients with AECOPD.
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<p><b>OBJECTIVE</b>To study the clinicopathologic characteristics of primary renal hemangioblastoma.</p><p><b>METHODS</b>The morphologic features, immunophenotype and molecular findings of 3 cases of primary renal hemangioblastoma were studied, with review of literature.</p><p><b>RESULTS</b>The age of patients ranged from 43 to 57 years. There were 2 women and a man. The patients often presented with renal mass. Histologically, the tumors were surrounded by thick fibrous capsule and composed of epithelioid or spindle cells. Two cases had a prominent stromal component and the other one was rich in capillary network. Lipid vacuoles were observed in all cases. Features of hemorrhage were demonstrated in 2 cases. Capsular invasion and necrosis were seen in 1 case. Immunohistochemical study showed that the stromal cells were positive for alpha-inhibin (3/3), S-100 protein (3/3), EGFR (2/2), PAX-2 (2/2), PAX-8 (2/2) and CA9 (2/2) but negative for CKpan (2/2) and HMB45 (2/2). Focal membranous staining for CD10 (3/3) was noted. No VHL gene mutations or chromosome 3p deletion were detected in the 2 cases studied.</p><p><b>CONCLUSIONS</b>Renal hemangioblastoma shows distinctive morphologic appearance with a wide range of variation. The unexpected positive staining for PAX-2, PAX-8 and CD10 in renal hemangioblastoma needs to be aware. Immunohistochemical study may be helpful in differential diagnosis of these renal tumors.</p>
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Objective To study the application value of diluted serum and EXcelland MVS in the linear performance verifica-tion.Methods The series of concentration samples were prepared by mixing the collected low value mixed serum and the low value mixed serum diluted with 2-3 times of deionized water and the same high concentration serum for conducting the linear experi-ments.The linearity of the experimental results was statistically judged by the two softwares of EXcelland MVS.Results The 3 diluted serum experiments were linear by the judgement of the two softwares;in 6 experiments,the original serum experimental re-sults of CREA were linear by the judgement of EXcelland nonlinear by the judgement of MVS,but the decisive concentration lev-els,the differences of the two regression equations were -2.02 μmol/L and 4.23 μmol/L respectively,which were less than 1/9 of CLIA′88 maximum allowable error under the two concentrations(26.52 μmol/L and 39.78 μmol/L),the remaining 5 experiments were linear by the judgement of the two softwares.Conclusion The low value serum appropriately diluted by deionized water does not affect the linear performance verification;in the linear performance verification,EXcellcan meet the verification needs and MVS is more strict in judging linearity.