Objective To explore the effect of high positive end-expiratory pressure (PEEP) for the treatment of neurological pulmonary edema (NPE) in patients undergoing mechanical ventilation,and to look for the best mechanical ventilation strategy to improve the prognosis.Methods A prospective study was conducted,and 120 patients with NEP admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Guangxi Traditional Chinese Medical University from January 2010 to August 2013 were enrolled and divided into two groups according to random number table (n=60 in each group).The patients in two groups were given empiric treatment for the disease,and they underwent mechanical ventilation.In the normal PEEP group PEEP was 3-10 cmH2O (1 cmH2O =0.098 kPa),and in the high PEEP group PEEP was 11-30 cmH2O,and all the rest parameters were the same.Clinical indices before and 7 days after treatment,and 28-day morality rate were compared between two groups.Results The 28-day morality rate in high PEEP group was obviously lower than that in the normal PEEP group [25.0％ (15/60) vs.65.0％ (39/60),x2=6.465,P=0.011].The clinical signs in both groups were improved after treatment.Compared with the normal PEEP group,the clinical indices in high PEEP group were more significantly improved.There were significant differences in body temperature (℃ 37.4 ± 0.5 vs.38.5 ± 0.6),respiratory rate (times/min 18.3 ± 3.1 vs.23.3 ±3.5),heart rate (beats/min 94.7 ±8.5 vs.113.5 ±8.0),white blood cell count [WBC (× 109/L) 12.5 ±2.1 vs.17.1 ± 1.7],acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (15.6 ± 3.2 vs.19.8 ± 3.7),Glasgow coma score (GCS 12.5 ± 2.1 vs.8.5 ± 2.9),gastrointestinal dysfunction score (3.9 ± 3.0 vs.3.6 ± 2.4),oxygenation index [PaO2/FiO2 (mmHg,1 mmHg=0.133 kPa) 196.5 ± 45.1 vs.134.1 ± 22.3],serum creatinine [SCr (μmol/L) 86.5 ± 35.6 vs.98.5 ± 37.7],total bilirubin [TBil (μmol/L) 39.7 ± 23.5 vs.41.5 ± 16.2],C-reacting protein [CRP (mmol/L) 53.7 ± 21.4 vs.108.4 ± 26.3],prothrombin time [PT (s) 15.0 ± 2.1 vs.20.4 ± 2.2],activated partial thromboplastin time [APTT (s):37.3 ±4.9 vs.56.7 ± 13.6],international normalized ratio (INR 2.52 ±0.64 vs.4.01 ±0.77),extra vascular lung water index [EVLWI (mL/kg) 7.53 ± 1.21 vs.15.85 ±3.41],pulmonary vascular permeability index (PVPI 6.07 ± 0.89 vs.9.47 ± 1.26),mean arterial pressure [MAP (mmHg) 87.3 ± 10.9 vs.98.7 ± 13.6],cardiac output [CO (L/min) 7.15 ± 1.42 vs.5.65 ± 1.82],systemic vascular resistance index [SVRI (KP) 112.4 ± 9.5 vs.136.5 ± 11.9],and blood lactate (mmol/L:2.53 ± 1.23 vs.5.81 ± 2.17) between high PEEP group and normal PEEP group (P＜0.05 or P＜0.01).Conclusion Prognosis can be improved in NPE patients with the use of high PEEP in mechanical ventilation.

Objective To assess the safety of emergent invasive treatment in severe postpartum hemorrhage. Methods Invasive treatment was performed in 18 patients with severe postpartum hemorrhage. The operation time, therapeutic effect, collateral circulation of uterus feeding arteries, pathological changes in uterine muscle after embolization and radiation dose received by the ovary during operation were investigated for safety assessment. Results (1) All eighteen patients who had been failed to conservative treatment were successfully cured with invasive treatment. The duration of hemostasis was 3 to 10 minutes, mean time (6?4) minutes. The operation time was 30 to 50 minutes, mean time (39?5) minutes. (2) Although both sides of internal iliac arteries or uterine arteries were embolized, a small amount of blood supply for uterus remains from ovary arteries, from branches external iliac arteries and from other arteries. (3) Uterine biopsies were performed in 3 patients 5 to 10 days after the invasive treatments for pathological examinations. Pathological findings showed that the necroses of uterine muscles were disconnected and the whole areas were blow 1/4. (4) The mean radiation dose received by the ovary in 5 cases was (17?7) cGy, which was within the safe limit. Conclusions The use of the emergency invasive treatment is safe in severe postpartum hemorrhage.

Objective To investigate the awareness of knowledge,attitude and behavior about disinfection and sterilization among clinical health care workers (HCWs).Methods 200 clinical HCWs were investigated randomly by using questionnaires.Results The average awareness rates of knowledge,attitude and behavior about disinfec-tion and sterilization among HCWs were 71 .49%,63.79%,and 86.45% respectively.The awareness rates of knowledge about the expiration dates of sterilized articles,classification of infectious diseases,and biological moni-toring were 49.43%,42.53%,and 23.56%,respectively;HCWs’attitude towards disinfection and sterilization:awareness rate of whether they paid attention to the new technology in specialty of central sterile supply was the lowest (26.44%);86.45% of HCWs thought they could master the aseptic operation technique,correct applica-tion method for sterile apparatus and related items,but easily ignored to check the integrity of aseptic packages and indicators before operation (67.24%).Conclusion The knowledge,attitude and behavior about disinfection and sterilization among HCWs still need to be improved,training on knowledge about disinfection and sterilization among HCWs should be strengthened.

Objective To investigate the information access, its influencing factors and related problems in under-graduates of medical colleges and universities.Methods Information access in undergraduates of medical colleges and universities was investigated with questionnaires.Results It was the tendency to search information on Internet using mobile phone, the interest in information access on Internet was affected by the coverage of WiFi, audio and visual frequencies were the important resources, problems existed in the matching of web page and intelligent mobile phone.Conclusion Information access in undergraduates of medical colleges and universities is affected by the software and hardware of mobile phone and network communication cost, and the healthy use of mobile phone is influenced by social environment in undergraduates of medical colleges and universities.Mobile phones greatly influence the reading forms in undergraduates of medical colleges and universities and the spreading ways of medical information.

Objective To explore the relationship between KAI1 gene expression in papillary thyroid carcinoma and clinicopathological features and prognosis. Methods KAI1 mRNA expression was detected by Real Time Polymerase Chain Reaction in 21 cases papillary thyroid carcinoma tissues and 21 cases adjacent normal tissues, as well as 7 cases benign thyroid disease tissues. KAI1 protein expression was detected by immunohistochemisty in 60 cases papillary thyroid carcinoma tissues and 20 cases thyroid adenoma tissues. Results KAI1 mRNA expression in papillary thyroid carcinoma was significantly higher than that in adjacent normal tissues (P ＜ 0. 05) and benign thyroid lesion tissues (P ＜ 0. 05). Positive expression rate of KAI1 protein was 68. 3% in papillary thyroid carcinoma and 25% in thyroid adenoma tissues. The difference was statistically significant (P ＜0. 01). In papillary thyroid carcinoma, positive expression rate of KAI1 protein in the group without lymph node metastasis was higher than that in group with lymph node metastasis (P＜0.05). There was no difference in positive expression rate of KAI1 protein for male or female patients (P ＞0. 05). KAI1 protein expression in papillary thyroid carcinoma was not related to patients' ages, tumor size, TNM staging or capsule invasion (P ＞ 0. 05). Conclusions The abnormal expression of KAI1 mRNA and protein is correlated to the genesis and progress of papillary thyroid carcinoma,which provides a clue for treatment and prognosis assessment of papillary thyroid carcinoma

Objective To study the clinical effects of Ditan Xingnao Chengqi soup for treatment of patients with sepsis brain dysfunction. Methods Sixty-two cases of sepsis brain dysfunction were divided into treatment group(32 cases)and control group(30 cases)according to random digits table. Both groups received general clinical treatment,while the treatment group additionally accepted Ditan Xingnao Chengqi soup through nasal feeding. The changes of C-reactive protein(CRP)of two groups before treatment and after treatment for 12,24,48,72 hours and 1 week were observed. Besides,the Glasgow Outcome Scale(GOS)was used to assess the curative effect of two groups, and its clinical significance was judged. Meanwhile,the hospitalization costs,the times staying in hospital and total effective rates of the two groups after treatment were observed. In addition,cost-effectiveness analysis was carried out. Results With the extension of therapeutic time,the levels of CRP(mg/L)in the two groups were reduced effectively in comparison with those before treatment,and the change was more obvious in the treatment group;after treatment for 24 hours,the difference in the level of CRP between the two groups began to be statistically significant(106.5±22.3 vs. 201.6±25.4,P<0.05). The GOS of two groups after treatment had been increased markedly in comparison to that before treatment,and the change was more obvious in treatment group(72 hours:10.34±0.76 vs. 7.34±0.48,1 week:13.16±0.86 vs. 9.56±0.64,both P<0.05). Hospitalization costs(yuan)of treatment group in intensive care unit (ICU)was lower than that in control group(43276.16±1844.23 vs. 51347.75±2011.06,P<0.05),and the duration of staying(day)in ICU of treatment group was shorter than that in control group(15.11±2.25 vs. 20.30±2.97,P<0.05). The total effective rate of treatment group was higher than that of control group,but the difference had no statistical significance(87.5%vs. 60.0%,P>0.05).The ratio of cose effectiveness analysis in treatment group was smaller than that of control group(497.42 vs. 855.80,P<0.05). Conclusions Ditan Xingnao Chengqi soup has a relatively good effect on antagonizing inflammatory factors,controlling excessive inflammatory response and improving disturbance of consciousness. The early intervention with this agent for a patient with sepsis cognitive impairment can control the disease situation,improve the patient's prognosis and reduce his or her hospitalization costs.

Objective To establish a method of murine local lymph node assay (LLNA) combined with measurement of ear swelling for the identification of photosensitive agents. Methods The female BALB/c mice received test chemicals or vehicle alone on the back skin of both ears and then were exposed to UVA irradiation on three consecutive days. The post-auricular lymph nodes draining the ear tissue were excised 24 h following the last irradiation. Lymph node cell counts and lymphocyte proliferative rates were determined, which indicated lymph node hyperplasia. While ear swelling was also measured, to reveal skin irritating reactions. Some cytokines (IFN-?, IL-2 and IL-4) released by the draining lymph node were also analyzed by ELISA. Results Tetrachlorosalicylanilide, a strong photoallergen, caused lymph node hyperplasia without ear swelling. The mild photoallergen (6-methylcoumarin) showed neither lymph node proliferation nor ear swelling reactions. But 8-methoxypsoralen, a phototoxic substance, induced both lymph node hyperplasia and ear swelling. The level of IL-4 was significantly increased when the mice were previously sensitized with tetrachlorosalicylanilide (P

Objective To investigate the relevant mechanism of different concentrations of Shenqi YiliuDecoction medicated serum on blocking cell cycle and inhibiting invasion and metastasis of gastric cancer cell lines MKN-45. Methods Sixty SPF Wistar rats were randomized intoShenqi Yiliu Decoction low-, medium-, and high-dose groups and control group, with 15 rats in each group. Low-, medium- and high-dose groups were fed with different concentrations of TCM liquid from which containing crude medicine (0.25, 0.50, 1.00 g/mL) separately for gavage. Rats in the blank group were given the same amount of drinking water for gavage, twice a day, for 7 days.2 h after the last gavage, rat blood was taken and serum was separated. After MKN-45 cells were dealt with different concentrations of medicinal serum, FCM was used to detect cell cycle and immunohistochemistry technology was used to detect the expressions of COX-2 and PTEM proteins.Results FCM analysis showed that medicated serum could increase G0-G1 phase and shorten S phase of cells; medicated serum could reduce the positive expression rate of COX-2 of the MKN-45 cells and increase positive expression rate of PTEN proteins (P<0.05).ConclusionShenqi YiliuDecoction medicated serum can block the cell cycle and inhibit invasion and metastasis of MKN-45 cell lines, which may be related to the intervention in the expression levels of COX-2 and PTEN proteins.

Objective:To investigate the relationship between high mobility group box-1 protein (HMGB1) expression and gut mucosal barrier dysfunction during murine severe acute pancreatitis (SAP). Methods:Forty-eight male health adult Wistar rats were divided randomly into Control group and SAP groups. The concentration of plasma D-lactate and the activity of myeloperoxidase (MPO) in the intestinal tissue were determined. The expression of HMGB1 mRNA in intestinal mucosa was detected by reverse transcription polymerase chain reaction (RT-PCR) and the activity of HMGB1 was determined by Western blot. Results:Plasma D-lactate and MPO reached a peak level at 24h (16.41?4.65)?g/mL for Plasma D-lactate and(26.76?3.63)U/g for MPO respectively, (P

Objective To evaluate the values of combined detection of soluble mesothelin related proteins (SMRP)and carbohydrate antigen 1 25 (CA1 25)in the diagnosis of malignant peritoneal mesothelioma.Methods 20 patients with malignant peritoneal mesothelioma were selected as the malignant group,50 patients with benign ovar-ian tumor were selected as the benign group,60 healthy women were selected as the control group.Enzyme -linked immunosorbent assay(ELISA)was adopted to detect serum SMRP levels and electrochemiluminescence immunifaction (ECLI)was adopted to detect serum CA1 25 levels.The SMRP,CA1 25 levels were compared among all groups,the sensitivity,specificity of SMRP and CA1 25 in the diagnosis of peritoneal malignant mesothelioma were analyzed. Results Serum levels of SMRP,CA1 25 in malignant group were (1 4.8 ±1 .6 )μg/L,(1 89.1 ±1 5.3 )μg/Lrespectively,which were significantly higher than those in the benign group[(3.9 ±0.9)μg/L,(28.6 ±4.2)μg/L] (t =27.40,49.61 0,all P <0.01 )and the control group[(2.8 ±0.7)μg/L,(1 6.9 ±3.8)μg/L](t =29.877, 53.334,all P <0.01 ).The sensitivities of SMRP,CA1 25 detection alone for malignant peritoneal mesothelioma diag-nosis were 65.0%,50%,respectively,while their specificities were 83.6%,79.1 %.The sensitivity and specificity of combined detection of SMRP and CA1 25 for malignant peritoneal mesothelioma were 95.0% and 93.6%.Conclusion SMRP has some value in the diagnosis of peritoneal malignant mesothelioma.SMRP combined with CA1 25 detection can markedly improve the diagnostic sensitivity and specificity for malignant peritoneal mesothelioma.