Objective To evaluate the application value of bronchofibroscope in severe pulmonary infection.Methods 60-severe pulmonary infections were diagnosed.They were divided into two groups by random digits table.The control group were treated with conventional therapy (include:antibiotic therapy,eliminate sputum、nutritional support,and so on).The observation group were treated with not only conventional therapy but also bronchial lavage and antibiotic therapy by bronchoscope.Indicatrix and curative effect of clinical were analyzed by statistics-software.Results After treatments,The time of hemogram recoved (11.50 ± 4.31) days,and the time of Clinical symptom dispersal(12.31 ± 2.30)days and the time of fever(7.02 ± 2.23)days in the observation group were all shorter than those of control group [(16.11 ± 5.21) days,(20.09 ± 5.19) days,(11.04 ± 3.31) days].All comparisons were statistical significance(t =5.03,6.87,6.22,all P ＜ 0.05).The total effective rate was 88.5％ in the observation group,whcih was efficienter than that of the control group (62.5 ％) (x2 =4.36,P ＜ 0.05).Conclusion It is effectively to use a bronchial lavage and antibiotic therapy treated severe pulmonary infections by bronchoscope.

Objective To observe the effect of minocycline hydrochloride sustained-release agent on interleukin-6 (IL-6) in gingival sulcus fluid of patients with chronic periodontitis.Methods One hundred and twenty patients with chronic periodontitis were randomly divided into two groups,the control group(n =60 cases) and the treatment group(n =60 cases).The patients in the control group were treated through oral tinidazole.The patients in the treatment group were given topical application of minocycline hydrochloride sustained-release agent.The plaque index,probing pocket depth,bleeding on probing rate and IL-6 in gingival sulcus fluid were detected before and after treatment.Results The plaque index,probing pocket depth,bleeding on probing rate were decreased after treatment.There was a significant difference between two groups(P ＜ 0.05).IL-6 level was decreased after treatment.There was a significant difference between two groups (P ＜ 0.05).Conclusion Minocycline hydrochloride can improve patients with chronic periodontitis through mitigating inflammation.

An unusual case of primary cutaneous anaplastic large cell lymphoma induced by influenza vaccination is reported.A 79-year-old man developed an erythematous nodule at the injection site on the upper left arm 2 months after vaccination against influenza A virus,which gradually grew and ulcerated.Pathological examination of the lesion revealed epidermal infiltrate of lymphocytes and numerous clumps of densely distributed lymphocytes with lightly stained cytoplasm,nuclear atypia and karyokinesis.Immunohistochemistry showed that the tumor cells stained positive for CD3 (90％),CD5 (90％),LCA (90％),CD30 (90％),CD10 (a few),Ki-67 (80％),but negative for CD20,CD56,cytokeratin 1-3,epithelial membrane antigen,synaptophysin,and anaplastic lymphoma kinase.The patient was diagnosed with primary cutaneous anaplastic large cell lymphoma at the injection site following vaccination against influenza A virus.

Objective To study the influence of excessive magnesium and/or deficient calcium intake on the bone mass of ovariectomized rats. Methods Three-month-old ovariectomized rats were fed with different types of drinking water: Interaction group was fed with deficient-Ca and excessive-Mg water: Ca 5 mg/L, Mg 60 mg/L; Excessive-Mg group was Ca 60 mg/L, Mg 60 mg/L; Deficient-Ca group was Ca 5 mg/L, Mg 30 mg/L; Normal group was Ca 60 mg/L, Mg 30 mg/L. After 3 months of treatment, the left femur was measured with the length and weight, then the content of Ca and Mg were determined, right femur was X-rayed, and right tibia was taken for the pathological examination. Results Calcium deficiency in water caused significant changes in all of the bone mass indexes, magnesium excess in water showed a tendency of Ca decreasing and Mg increasing in the bone. It was easily distinguish the difference in bone mineral and bone microstructure by X-ray and pathological examination: control group was the best, then was Mg excess group, Ca deficiency group was inferior, and the interaction group was the worst. Conclusion Calcium deficiency is one of the major reasons of osteoporosis, while the excessive intake of magnesium may not only disturb the bone metabolism but also aggravate the adverse effect of Ca deficiency on bone mineral and bone health.

One hundred and fifty-seven cases of Graves' disease were divided into three groups according to their clinical features and thyroid functions: Group A, untreated; group B, treated but uncontrolled or relapsed; group C, treated and remitted. The positive rates of TSH receptor antibody (TRAb), anti-tnyroglobulin antibody (TgAb), anti-microsomal antibody (TmAb), anti-DNA antibody and anti-nuclear antibody (ANA) were 91.2, 79.4, 79.4, 70.6 and 23.5% respectively in group A. The positive rate of TRAb and TBII were significantly different between group C and group A or B (both P

Objective To investigate fracture patients' perception about pain and analgesic.Methods In-depth interview for 30 min was done for 20 fracture patients within 12 h after their admission.Data were analyzed based on Colaizzi phenomenological research method.Results Fracture patients underestimated the influence that pain had dosne to them.When they were suffering from pain,most of them chose to endure until they couldn't endure anymore.For analgesics,most of them chose to avoid from using them unless they couldn't endure anymore.Conclusions Pain management education should be done to help patients correct their bias about pain,know more about analgesics according to their personal conditions,and help them self-report their pain and manage their pain timely and properly.

Objective:To determine whether lornoxicam has a preemptive analgesic effect to the patients who undergo modified radical mastectomy.To study the effect of lonoxicam on platelet function and investigate the surface expression of p-selectin on platelet by a flow-cytometric assay.Methods:After obtaining a written informed consent from patients,sixty ASAⅠ-Ⅱpatients,aged 40-60 yr,weighted 40-60 Kg,who were scheduled for modified radical mastectomy were included in the study.All patients were randomly divided into two groups.Patients underwent breast surgery under general anesthesia,Group I was administered 16mgof lornoxicam iv.30 minutes prior to surgery,Group Ⅱ was administered 4 mL placebo.Two mL blood was drawn from a peripheral vein to analyze the surface expression of p-selectin on platelet,blood sample was collected at three time points:30 minutes prior to surgery,6h and 24h after surgery.Introoperative blood loss and the volume of drainage fluid 24h,48h,and 72h after surgery was documented;PONV and other side effects was recorded.The rescue analgesics was recorded.Result:Group I demonstrated reduced pain scores compared to Group Ⅱ at three specific time points;Great difference for the expression of p-selectin on platelet at certain time point in each group was noted,the postoperative express was higer than that of the preoperation;there were no difference for the expression of p-selectin on platelet between two groups.There were no difference in introoperative blood loss and the volume of drainage fluid between two groups;Great difference for the rescue analgesics was recorded,GroupⅡdemends more analgesics than GroupⅠ.The rate of PONV was similar between two groups,no other side effects were recorded.Conclusion:Lornoxicam administered preemptively appears to reduce pain scores after surgery,which can improve the quality of postoperative analgesia.Lornoxicam has no significant effect on platelet activation and aggregation with only one dose before surgery,there is no effect in the quality of blood coagulation.Lornoxicam may be safely used in perioperative period.

Objective:To explore the approaches and ideas for the pharmaceutical care performed by clinical pharmacists for the patients with bone tuberculosis and tubercular meningitis. Methods:Pharmacists participated in the clinical consultation for one patient with bone tuberculosis and tubercular meningitis. The methods and effect of clinical pharmacists were analyzed comprehensively in re-spect of the adjustment of anti-tuberculosis treatment scheme according to the disease condition, attention pald to the adverse reactions of anti-tuberculosis drugs, medical education for the patient and so on. Results: During the treatment, clinical pharmacists did have some actions to assist doctors in rational drug use, and the suggestions of clinical pharmacists in the consultation obtalned clinical rec-ognition, which significantly improved the effect of the medication. Conclusion:Clinical pharmacists can perform individual pharma-ceutical care for patients and help clinicians optimize drug therapy, which can improve the safety and efficacy of medication.

Along with the transformation of the pattern of the medicine and the development of dental medicine,more and more patients accept orthodontic treatment.The patients have higher expectations of the treatment.As a result,the abilities to make clinical communication for orthodontic postgraduates should be improved.The article discusses how to improve the orthodontic postgraduates' abilities in the hope that it will be of some help to them.

Objective To assess whether mTOR was activated in peripheral T lymphocytes of acute coronary syndrome (ACS)patients and to investigate the relationship among mTOR,regulatory T cells and cytokins. Methods Patients with acute coronary syndrome (n=32) were selected in ACS group. Meanwhile, patients who complainted of chest pain but were proven to be normal in ECG and in coronary arteriography, were excluded as ACS patients but were diagnosed as Chest Pain Syndrome (CPS) and selected in CPS group (n=28). The expression levels of mTOR, phospho-p70S6KT389 (indicative of mTORC1 activity) and phospho-AKTS473(indicative of mTORC2 activity) were investigated in T cells, which were isolated from peripheral blood of patients in ACS group or CPS group, using Western blot. The proportion of CD4+CD25+Foxp3+Tregs over CD4+cells were evaluated by FACS. And T cell subset related cytokines such as IFN-γ, IL-4, IL-17 and TGF-β1 were exam?ined by ELISA. Then we investigated the relationship among mTOR,regulatory T cells and cytokins by Spearman analysis. Results mTOR and p-p70S6KT389 expression were significantly enhanced in ACS group as compared with those in patients from CPS group (P<0.01). Higher levels of IFN-γ, IL-17 but lower level of TGF-β1 cytokines as well as decreased propor?tion of Tregs were observed in ACS group than those in CPS group (P<0.05). There was no significant difference in the level of IL-4 and p-AKTS473 between the two groups (P>0.05). By correlation analysis, p-p70S6KT389 expression level positively correlated with IFN-γ, IL-17(rs=0.91,092,P<0.01)and negatively correlated with Tregs and TGF-β1(rs=-0.85,-0.80, re?spectively, P<0.01). Conclusion mTORC1 pathway was activated in peripheral T lymphocytes of ACS patients, and Tregs insufficiency and cytokins imbalance both contribute to the activation of mTORC1 pathway and pathological process of ACS.