Objective To observe the clinical effects of ambroxol on acute stroke-associated pneumonia (SAP).Methods From July 2011 to December 2012,a total of 82 patients with strokeassociated pneumonia (SAP) admitted to our hospital were selected and randomly divided into ambroxol group (n=43,treated with ambroxol in combination with antibiotic therapy) and control group (n =39,treated with antibiotic therapy).The defervescence time,hospitalization time,antibiotic use time,C-reactive protein level,blood oxygen partial pressure,bacterial clearance rate and the total effective rate were compared between the two groups.Results The defervescence time,hospitalization time,antibiotic use time were shorter in ambroxol group than in control group [(3.1 ± 0.8)d vs.(3.8±1.1)d,(11.7±3.7)d vs.(13.6±4.9)d,(5.4±1.7)dvs.(6.6±2.1)d,t=18.60,22.80,23.50,P=0.014,0.008,0.011,repectively].Bacterial clearance rate and the total effective rate were higher in ambroxol group than in control group [90.7％ vs.74.4％,93.0％ vs.74.4％,x2 =3.86,5.34,P=0.05,0.02].There were no significant differences in changes of C-reactive protein level and blood oxygen partial pressure between two groups before and after treatment (all P＞0.05).Conclusions Ambroxol is an effective treatment for acute stroke associated pneumonia,which can shorten antibiotic use time and duration of symptoms and remove bacteria effectively.

This report presented a male patient aged 69 years,who was admitted into our hospital for fever,hemoptysis and chest pain.Chest X-Ray showed shadows on the right lung and pleural thickening.The effect of broad spectrum antibiotic therapy was poor.With the disease progressed,pleural effusion appeared on the right side.Blood culture showed methicillin-resistant staphylococcus aureus.Pleural effusion tests indicated pyothorax,but the effects of closed chest drainage and sensitive antibiotic therapy were poor.After disentangling with open thoracic exploration,the right middle lobe was resected and the right lung lobe pathology showed Wegener granulomatosis.His blood antineutrophil cytoplasmic autoantibodies was negative.The paranasal sinus CT scan and renal function showed no abnormalities.The definitive diagnosis was pulmonary limited Wegener granulomatosis.

Objective To explore the effect of Curcumae on acute hepatic injuried mice.Methods The model mice of acute hepatic injury were established with intraperitoneal injecting 0.2% carbon tetrachloride (CCl4) 0.2 ml/10mg. 48 mice were randomized into 6 groups: model group, control group, Ganlixin group (25 mg/kg) and three treating groups of Curcumae which were administrated by gavage at the doses of 2.5 g/kg, 5 g/kg, 10 g/kg once everyday.7 d later, all mice were put to death. The liver index, the activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in serum, the activities of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in hepatic tissue were observed. Pathological change was observed under HE staining. Results Compared with the model group, Curcumae could decrease the liver index and the activities of ALT and AST in serum, MDA in hepatic tissue significantly (P<0.05), and increase the activities of SOD (P<0.05). The pathological changes were less in three treating groups than that of the models. Conclusion Curcumae can protect the liver from acute hepatic injuried induced with CCl4 in mice.

Objective To observe the effect of Yujin on cerebral function of acute hypoxia mice.MethodsThe acute hypoxia mice model was reproduced by cutting heads and establishing normal-pressure and closed hypoxic experimental settings. In yujin groups, the mice were treated with Yujin at the doses of 10 g/kg, 20 g/kg, 40 g/kg respectively through the intragastric tubes everyday. 6 days later, the mice survival time, the open-mouth times after cutting heads and the breathing time were observed. The activity of superoxide dismutase (SOD) and content of maleic dialdehyde (MDA) in cerebral tissues were measured. The morphological changes of the cerebral tissues under the microscope were examined.ResultsYujin could significantly prolong the survival time ( P<0.001) and the breathing time and increase the open-mouth times ( P<0.05～0.001), increase the activity of SOD ( P<0.001) and decrease the content of MDA ( P<0.01～0.001) in cerebral tissues. Compared with control group, the Yujin group mice had no obvious pathological alteration except some cerebral vascular dilatation.ConclusionYujin has an obvious protective effect on cerebral tissues of acute hypoxia mice.

Objective To explore the therapeutic effect of Cefoselis sulfate and Cefepime on the stroke-associated pneumonia in elderly patients.Methods 96 cases of stroke-associated pneumonia with positive pathogen were divided into two groups treated with Cefoselis versus Cefepime respectively.Body temperature,leukocyte count,arterial partial oxygen pressure,the serum level of C-reactive protein (CRP) and bacterial clearance rate were observed before and after the treatment.The cefoselis sulfate group (n =48) or the cefepime group (n =48) was treated with 2.0 g Cefoselis sulfate or 2.0 g Cefepime every 12 hours for 7 to 10 days.Results In post-treatment versus pretreatment,both two groups showed that clinical symptoms and inflammatory indicators were improved,and the patient's body temperature,white blood cell count and neutrophil cell count,hs-CRP and arterial partial oxygen pressure were significantly decreased (all P＜0.05).Arterial partial oxygen pressure was better in post-versus pre-treatment (P＜0.05).The total effective rate was 87.5％ in Cefoselis sulfate group and 83.3％ in cefepime group (P ＞ 0.05).The bacterial clearance rate was higher (89.6％) in Cefoselis sulfate groups than in cefepime groups (67.9％) (P＜0.05).In posttreatments of Cefoselis sulfate groups versus Cefepime groups,white blood cell count and neutrophil cell count,hs-CRP and arterial partial oxygen pressure showed no statistically significant differences (all P ＞ 0.05).Conclusions Compared with Cefepime,Cefoselis has the similar anti-infection efficacy in the treatment of stroke-associated pneumonia.While,the bacterial clearance rate and the total effective rate are better in cefoselis group than in Cefepime group.

Objective:To conduct a systematic review and Meta-analysis of the efficacy and safety of Apatinib and tegafur in colonic cancer.Methods:With "Apatinib" "Tegafur" "Colonic cancer" as keywords, PubMed, Embase, Web of Science, Cochrane Library, WanFang Data, VIP, CNKI and CBM were searched from inception to December 2020 to collect randomized controlled trail about treatment for colonic cancer with Apatinib and Tegafur. Evaluated the portion remission and stable duration and progression-free survival. Meta-analysis was performed by using RevMan 5.3 software.Results:Meta-analysis showed that in colonic cancer patients, the portion remission and stable duration, tumor progression of Apatinib were not inferior to those of Tegafur ( RR=1.10, 95% CI: 0.71-1.71, P=0.640; RR=0.51, 95% CI: 0.28-1.32, P=0.205). But for progression-free survival, Apatinib was superior to Tegafur in overall patients( SMD=0.90, 95% CI: 0.42-1.37, P<0.000 1). Conclusion:In the treatment of colon cancer, compared with Tegafur, Apatinib can effectively improve the progression-free survival and has better overall survival.

Objective To observe the effect of panaxadiol saponins (PDS) on intellectual decline and cerebral lesion induced by destabilization of cervical vertebra in mice.Methods44 mice were randomly divided into the normal control group, model group, high PDS doses group and low PDS doses group with 11 animals in each group. The model of destabilization of cervical vertebra was established by operating and intraperitoneal injection of PDS performed in the PDS high doses group (14 mg/kg) and low doses group (7 mg/kg) once everyday for 50 days. The memory ability of mice was evaluated by the water-maze test and tittup platform experiment. 50 days later, all mice were executed and the activities of superoxide dismutase (SOD), lactic dehydrogenase (LDH) and the content of maleic dialdehyde (MDA), nitric oxide (NO) in encephalon were tested.ResultsIn the PDS groups, the incubation period and error times in water-maze test shortened significantly ( P<0.05), aod the reaction period in tittup platform experiment shortened and wrong times decreased obviously ( P<0.01) compared with the model group. The activities of SOD, LDH increased ( P<0.01), and the content of MDA and NO decreased ( P<0.01, P<0.05) in the PDS group compared with the model group.ConclusionPDS has certain protective and improving effect on the decline of memory ability and cerebral lesion induced by destabilization of cervical vertebra in mice.

Objective To investigate the clinical values of heparinase-modified thromboelastography(hmTEG)in heparin monitoring during continuous renal replacement therapy.Methods A total of 97 cases who were undergoing continuous renal replacement therapy(CRRT)in the intensive care unit of the 94th People's Liberation Army Hospital from Jan 2014 to Jun 2019 were enrolled in this stud-y.The patients were divided into TEG group and APTT group according to different means of heparin monitoring during continuous renal replacement therapy.In total,278 hemofilters were used in all the blood purification therapies.Complication of bleeding,CRRT time,total heparin dose and SOFA(sequential organ failure assessment)score of the patients were compared between the TEG and APTT groups.The filter life span and survival time in hospital were also compared using Kaplan-Meier analysis.Rusults Compared with APTT group,the total heparin dose in TEG group were significantly higher(P＜0.05).The CRRT time of patients and the average filter life span in TEG group were significantly longer than those of APTT group(P＜0.05).Compared to APTT group,the 28-day SOFA in TEG group was significantly lower(P＜0.05).Survival analysis showed that the 28-day risk of death in the patients of APTT group was 2.01 times higher than that in TEG group(P＜0.05).The 72-hour filter life of TEG group was significantly longer than that of APTT group(P＜0.05).Conclusion The use of hmTEG for monitoring heparin in blood purification should be superior in terms of safety and efficacy with longer filter life span and higher survival rate of patients.

Objective To investigate the prognostic value of plasma thrombomodulin(TM)in patients with septic shock.Methods A retrospective analysis was conducted on the clinical data of 180 patients with septic shock admitted to the intensive care unit of the 908th Hospital from May 2018 to November 2022.The patients were divided into survival group(106 cases)and death group(74 ca-ses)based on the 30-day follow-up outcomes.Propensity score matching(PSM)was used to match 57 surviving patients with 57 de-ceased patients in a 1∶1 ratio,based on confounding factors such as age,gender,underlying diseases,primary infection site,laborato-ry results and disease severity scores.TM and other coagulation molecular markers were compared between the two groups,and logistic regression,receiver operating characteristic(ROC)curve,survival and correlation analyses were performed.Results After PSM,the TM levels in the death group(18.3[13.2,22.3]TU/mL)were significantly higher than those in the survival group(13.7[9.0,18.3]TU/mL)(P＜0.05).Multivariate logistic regression analysis showed that TM was an independent risk factor for 30-day mortality in the patients with septic shock(OR=1.137,95％CI:1.023-1.262,P＜0.005).ROC curve analysis revealed that the areas under the curve(AUCs)for predicting 30-day mortality were 0.665,0.627 and 0.600 for TM,Acute Physiology and Chronic Health EvaluationⅡ(APACHE Ⅱ)and Sequential Organ Failure Assessment(SOFA)scores,respectively.Kaplan-Meier survival analysis stratified by the optimal TM cut-off value(17.9 TU/mL)showed that the 30-day survival rate of the TM＜17.9 TU/mL group was 1.56 times that of the TM≥17.9 TU/mL group(Log-Rank test,P＜0.000 1).Spearman correlation analysis demonstrated that TM levels were positively correlated with APACHE Ⅱ(r=0.10,P＜0.005)and SOFA scores(r=0.35,P＜0.005).Conclusion Plasma TM has showed a good predictive value for assessing the prognosis of patients with septic shock and may serve as a potential biomarker for determining the prognosis of septic shock.

Objective To summarize the clinical features,serological features,blood transfusion protocols and treatment of 3 cases of passenger lymphocyte syndrome(PLS)after ABO-incompatibility liver and renal transplantation in our hospital,in order to provide guidance for comprehensive clinical understanding and recognition of this disease,especially early recogni-tion and treatment.Methods By collecting the basic information of the patients and the time of cross-matching incompatibility of homologous blood after transplantation,observing the skin yellow staining,detecting hemoglobin value and other hemolysis indexes,and blood group serological detection results before and after transfusion,the diagnosis and analysis were performed.The diagnosis and treatment effect of PLS were analyzed by collecting the clinical outcome information after immunization and blood transfusion.Results Three cases of ABO-incompatible liver transplantation showed decreased hemoglobin and hemoly-sis,incompatible cross-matching of homologous blood,and anti-A and anti-B IgG antibodies were confirmed by serological test.After treatment such as immunosuppression and plasma exchange,blood transfusion was effective,hemolysis was im-proved,and antibodies gradually disappeared.Conclusion ABO blood group antibody screening,unexpected antibody screening and direct antiglobulin test(DAT)should be performed regularly for ABO-incompatible liver and renal transplantation cases,in order to detect the PLS early.A series of laboratory tests related to PLS should be performed in time to diagnose and adjust the treatment plan,including transfusion strategy,when homologous cross-matching is incompatible.