Objective:To observe the therapeutic effects of lung protective ventilation on acute lung injury caused by chest trauma and seawater.Methods: Acute lung injury was induced in 18 healthy dogs by open pneumothorax and seawater and the dogs were then randomly divided into 3 groups: non-treatment group(received no treatment),common treatment group(nasal ventilation,thoracic drianage and intravenous 5% glucose solution) and lung protective ventilation group(mechanical ventilation,thoracic drianage and intravenous 5% glucose solution).Blood samples were taken at different time points to observe the changes of blood gas(PaO_(2),PaCO_(2)and PaO_(2)/FiO_(2)),hemodynamic parameters(heart rate,mean blood pressure,cardiac output) and cytokines(TNF-?,IL-4 and IL-8).Results: After injury,PaO_(2) declined significantly in the dogs,PaO_(2)/FiO_(2) was lower than 300 and the levels of TNF-?,IL-6 and IL-8 were increased obviously.PaO_(2),PaO_(2)/FiO_(2) and TNF-? level were significantly higher in lung protective ventilation group than those in common treatment group(P

Objective To investigate the change of serum cancer antigen(CA) 125 in patients with pleural effusion.Methods One hundred and twenty-eight patients with pleural effusion were admitted to the Naval General Hospital of People's Liberation Army from January 2010 to September 2012 were selected as our subjects.The level of serum CA125 was measured.The difference of serum CA125 positive rate and level were compared according to gender,pleural effusion nature,quantity and pleural effusion chest area; And the difference of patients with malignant pleural effusion tuberculosis,inflammatory,exudative pleural effusion based on above indicators.The correlation between serum CA125 level and pleural effusion depth were analyzed.Results The positive proportions of CA125 were 83.3％ (35/42) and 76.7 ％ (66/88) of patients with malignant and benign effusion respectively,and there was no significant difference (x2 =0.74,P ＞ 0.05).The serum CA125 level of patients with malignant pleural effusion was significantly higher than benign ones ((177.8 ± 31.4) U/ml vs.(110.6 ± 13.6) U/ml,t =31.24,P ＜ 0.05).There were no significant difference in the positive proportion of serum CA125 between malignant,tuberculous,inflammatory and transudative pleural effusion(75.8％ (25/33),70.0％ (20/29),87.5％ (21/24) and 83.3％ (35/42),P ＞ 0.05).Serum CA125 levels of patients with malignant pleural effusion were significantly higher than that with inflammatory ((177.8 ± 31.4) U/ml vs.(72.5 ± 12.8) U/ml,P ＜ 0.05),but the differences were not significant among malignant,tuberculous and transudative pleural effusion group((140.6 ± 28.2) U/ml,(154.3 ± 30.5) U/ml,P ＞ 0.05).The serum CA125 levels of patients with small,moderate and large effusions were (56.4 ± 18.2) U/ml,(120.2 ± 24.5) U/ml and (185.5 ± 34.6) U/ml respectively,and the difference among these groups were significant(F =296.03,P ＜ 0.05).Serum CA125 levels was positively correlated with pleural fluid depth (r =0.56,P ＜0.01).Different gender,pleural effusion parts serum CA125 positive rate and the different levels were not statistically significant (P ＞ 0.05).Conclusion Serum CA125 increased in patients with benign and malignant pleural effusion,and serum CA125 was not severed as the diagnosis biomarker in differentiating benign and malignant pleural effusion.Serum CA125 levels is helpful in monitoring the change of pleural fluid size due to the relation with depth of pleural fluid.

Objective To investigate the effects of dexamethasone on absorption of lung edema in rabbits with seawater drowning-induced acute lung injury.Methods Seawater(4 ml/kg body weight)was instilled into the lower trachea of ventilated and anesthetized rabbits.These rabbits were assigned randomly to receive intravenous injection of 1 mg/ kg body weight of dexamethasone(dexamethasone group,DG)or 2 ml of normal saline(control group,CG).Lung edema was measured by extravascular lung water index(EVLWI)using a gravimetric method.Three hours after treatment, epithelial Na~+ channel subunit-?(?-ENaC)mRNA and Na~+/K~+-adenosine triphosphatase subunit-?l(NKA-?l) protein abundances in lung tissues were respectively measured by reverse transcriptase-polymerase chain reaction and Western blotting,and NKA activity was measured by monitoring the release of inorganic phosphate(Pi)from adenosine triphosphate(ATP).Results The DG's EVLWI was significantly lower than the CG's[(0.508?0.089)vs.(0.648?0.102),P＜0.05)],but the DG's NKA activity,?-ENaC mRNA and NKA-?l protein abundances were significantly higher than the CG's,correspondingly(P＜0.05).Conclusions With up-regulation of the NKA activity and expressions of?-ENaC and NKA-?l,dexamethasone treatment could promote the absorption of lung edema in rabbits with seawater drowing-induced acute lung injury.

0.05). CONCLUSION: Serum Cys C is significantly increased in ARF and correlated well with the severity of ARF. Serum Cys C can be one of the detectable markers of ARF, but it is independent of the mortality and does not predict the prognosis of these patients.

Objective To investigate the influence of the nursing intervention on the ankle-brachial pulse wave velocity (PWV) and the ankle-brachial index (ABI) in patients with newly diagnosed type 2 diabetes mellitus. Methods Eighty patients with newly-diagnosed type 2 diabetes mellitus were selected and were completely randomly divided into the intervention group (40 patients) and the control group (40 patients). In the intervention group, the closed integrated nursing management mode was applied. Group health records were established and the nursing management group mode of chronic diseases was applied. The chronic disease management team was organized with specialist physicians, chronic disease specialist nurses and general practice nurses who were specialized trained and got related qualification. The whole team diagnosed patients in hospital and out of hospital, gave mental intervention and daily life guidance to patients (diet, sports and so on). Outside of hospital, the telephone follow-up was made every week; the regular family visit was made and the guidance was given to patients every month; the related presupposed indicators were tested every three months. All the patients who were enrolled in the chronic disease management team were given the pre-job training to fully understand their responsibilities, obligations, work contents, etc. in the team. They also signed the team's responsibility statement. In the control group the traditional diabetes nursing management mode was used. After two years intervention, the early detection atherosclerosis blood indexes (PWV and ABI) of patients in the two groups were compared. Results Before the intervention, there was no significant difference in the PWV or the ABI between the two groups (P> 0.05). After the intervention, the PWV in the intervention group was (1 552±462)cw/s, which was significantly different compared with that in the control group(1 613±417)cw/s (t=2.031, P=0.047). Moreover, in the intervention group, the PWV before the intervention was significantly different compared to the PWV after the intervention(t=2.533,P=0.008). After the intervention, the ABI was improved, but the ABI in the intervention group was not significantly different compared with that in the control group. In the intervention group, the ABI before the intervention was not significantly different from that after the intervention(P>0.05). Conclusions The closed nursing management mode can improve the PWV value in patients with newly diagnosed type 2 diabetes mellitus and delay the development of atherosclerosis.

Objective:To explore the relationship between serum matrix metalloproteinase-8 (MMP-8), myeloperoxidase (MPO), human cytomegalovirus (HCMV) infection and the type of carotid atherosclerosis in patients with ischemic cerebrovascular disease (ICVD).Methods:From February 2017 to May 2019, 90 patients with ischemic cerebrovascular disease diagnosed by Peking University Medical Rehabilitation Hospital were selected as study group and 90 healthy adult persons who underwent health checkup as control group, and the study group was divided into non-stable plaque type group (30 cases) and stable plaque type group (30 cases) according to the ultrasonic imaging data and referring to the type of carotid plaque of the patients. The patients whose plaque property were between the two groups were were enrolled as the middle type group (30 cases). The relationship between human cytomegalovirus PP65 antigen (HCMV-PP65) in the serum, MMP-8, MPO and peripheral blood white blood cells and carotid atherosclerotic plaque in patients with ischemic cerebrovascular disease was analyzed.Results:The serum MMP-8, MPO level and HCMV-PP65 positive rate in the 3 study groups were significantly higher than that of the control group ( P<0.05), and the serum MMP-8 in different plaque types groups was significantly higher in the study group and the control group than in the control group. The higher the level of MPO and the positive rate of HCMV-PP65, the higher the serum MMP-8 and MPO level in the middle plaque type group, and the positive rate of HCMV-PP65 in the middle plaque type group was higher than that of the stable plaque group and the unstable plaque group ( P<0.05). Conclusions:The serum MMP-8, the MPO level and the HCMV infection are related to the unstable type of the carotid atherosclerosis plaque in the patients with the ischemic cerebrovascular disease, and the recognition of the carotid atherosclerosis is improved; it is an important link to control the severity of patients with ischemic cerebrovascular disease and to take timely and effective prevention and treatment measures.

Objective? To explore the application effect of remote management mode for essential hypertensive patients in the army. Methods? By purposive sampling, a total of 70 male army cadres who had been diagnosed as essential hypertension admitted or during health check in the Sixth Medical Center of PLA General Hospital since 2017 were selected as the research objects. The remote management mode was adopted for them in the intervention. Re-examination was conducted for them one year after implementing the remote mode of management. The patients' blood pressure, lifestyle modification status, and related knowledge acquisition about hypertension were compared before and after the management. Results? The systolic and diastolic blood pressures of patients after intervention were lower than those before intervention, and the differences were statistically significant (P＜ 0.01). After intervention, patients' compliance with medication, salt control behavior, alcohol restriction and exercise were better than those before intervention, and the differences were statistically significant (P＜0.01). The score of hypertension related knowledge after intervention was higher than that before intervention,and the difference was statistically significant (P＜0.01). Conclusions? The remote management mode on blood pressure can achieve good effects in the blood pressure management of the patients with hypertension in the army.

Objective:To investigate the effect of "simulated Chinese medicine nursing clinic" teaching on syndrome differentiation ability among nursing students and the teaching effect of this method.Methods:A total of 325 students were randomly divided into conventional teaching group with 163 students (receiving conventional nursing teaching) and real situational teaching group with 162 students (receiving "simulated Chinese medicine nursing nursing clinic" teaching at the same time). A self-made questionnaire for syndrome differentiation-based nursing ability, assessment scores of traditional Chinese medicine nursing theories and skills, and a teaching satisfaction questionnaire were used for evaluation.Results:After intervention, the real situational teaching group (the treatment group and the experience group) had significantly higher socres of syndrome differentiation-based nursing ability (mastery of four diagnostic methods, diagnosis of syndromes, analysis of syndromes, determination of nursing principles, and development of nursing regimens) than the conventional teaching group (the treatment group and the conventional teaching group: 8.97±1.00/8.47±1.20/8.33±1.06/8.30±1.26/7.89±1.13 and 7.96±1.14/7.29±1.36/7.14±1.18/7.39±1.30/7.26±1.18, P<0.05; the experience group and the conventional teaching group: 8.39±1.10/8.17±1.15/8.07±1.06/7.97±1.26/7.73±1.38 and 7.96±1.14/7.29±1.36/7.14±1.18/7.39±1.30/7.26±1.18, P<0.05). The real situational teaching group had a significantly higher overall degree of satisfaction with teaching than the conventional teaching group [160 (97.6%) and 150 (92.0%), P<0.05]. Conclusions:The "simulated Chinese medicine nursing clinic" teaching program effectively enhances the thinking of syndrome differientiation and related abilities for nursing, improves the learning effect of traditional Chinese medicine nursing theories and skills, and increases the learning interest in traditional Chinese medicine nursing among nursing students.