Blood Gas Analysis ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; therapy ; Intensive Care Units, Neonatal ; Male ; Respiration, Artificial

ObjectiveTo observe the effect of nitrates and statins on blood pressure,serum lipid and artery structure of elderly patients with isolated systolic hypertension(ISH) and hyperlipidemia.Methods96 elderly patients with ISH and hyperlipidemia were randomly divided into the isosorbide mononitrate triple therapy group(group A),simvastatinelderly two drugs combination group(group B) and control group(group C) with 32 cases in each group.The group A was given isosorbide mononitrate,simvastatinelderly and felodipine.The group B was given simvastatinelderly and felodipine.The group C was given felodipine alone.The whole course lasted 12 weeks and the blood pressure,serum lipid and the change of artery structure were observed.ResultsThe effect of group A was significantly better than groups B and C(P<0.01). The effect of lowering serum lipid and change of artery intima-media thickness(IMT) in groups A and B were better than that in group C(P<0.05).ConclusionNitrates can decrease systolic blood pressure and pulse pressure,but has less effect on diastolic blood pressure.Statins can decrease IMT of the common arteries.The combination of nitrates and statins is speculated beneficial to elderly with ISH.

Purpose:To evaluate the effects of intraoperative radiotherapy for adenocarcinoma gastric cardia.Meth- ods:From Jan.1992 to Dec.2000 a trial on intraoperative radiotherapy for AGC was carried out in 38 patients.Whose age was younger than 75 years,at least on semiliquid diet and no contraindication of surgery.6MV or 9MV-E photon was used for the intraoperative radiation therapy to the cardia,lower segment of the esophagus,fundus,lesser curvature and hepato- gastric ligament.Results:Average follow up 65 months.The 5 year survival rates were 39.4%.Conclusions:Intraoperative radiation therapy is able to improve the results of surgery for adenocarcinoma of the gastric cardia.

Atherosclerosis ; Humans ; Urotensins

Objective To observe the influence of local-anaesthetic combined with dezocine on brachial plexus block and postoperative analgesia.Methods 60 patients scheduled for unilateral upper limb operation were randomly divided into two groups of C group and D group with 30 cases in each group.The brachial plexus block was performed under ultrasound guiding.Two groups received a bolus injection of local anesthetic 30ml,but the local bolus injection of D group consisted of Dezocine 10mg.The tine of sensory blocked producing effect,anesthesia effect,sensory blocked duration were observed.Two hours after sensory nerve recovered,the scores of VAS pain and Ramsay Sedation were recorded.Adverse reactions of perioperation were also observed(nausea,vomiting,dizzy,respiratory,urine retention,pruritus).Results The sensory blocked duration in D group was(7.1±1.1)h,which was significantly longer than that of C group[(4.5±0.8)h](t=10.47,P＜0.01);Two hours after sensory nerve recovered,the score of VAS pain in D group was(1.7±0.7)points,and significantly lower than that of C group[(3.9±1.0)points](t=9.87,P＜0.01).Both two groups had no adverse reactions.Conclusion Addition dezocine 10mg to local anesthetic solutions for interscalene brachial plexus block,it could prolong the sensory block duration,provide satisfactory postoperative analgesia,have no adverse reactions.

Objective To study the diagnosis value of serum retinol binding protein (RBP),cystatin C(Cys C) and β2 microglobulin (β2-M) in early renal injures of gcstational diabetes mellitus (GDM) patients.Methods 85 case of GDM pregnant women admitted to Shiyan Maternal and Child Health-Care Hospital from Jan.2009 to Jan 2015 were chosen as research objects,and were divided into simple diabetes group (35 cases),micro proteinuria group (30 cases) and massive proteinuria group (20 cases) according to the urinary albumin excretion rate (UAER),while 30 cases of healthy pregnant women were recruited randomly during the same period as control group.The 24h urine protein,serum RBP and renal function indicators [blood urea nitrogen (BUN),creatinine (Ser),Cys C and β2 M],the positive rates of RBP,Cys C,β2-M and combined detection of RBP,Cys C,β2-M of the four groups were compared.Results The 24h urine protein in simple diabetes group,micro proteinuria group and massive proteinuria group were significantly higher than that in the control group (t=3.91～ 16.33,all P＜0.01),the difference between the 3 groups were statistically significant (t=6.78～ 16.94,all P＜0.01).The levels of BUN,Scr,Cys C,β2-M and RBP in micro proteinuria group and massive proteinuria group were significantly higher than those in control group and simple diabetic group (t=3.68 ～ 18.54,all P＜0.01),there were significant difference in above indexes between micro proteinurine group and massive proteinuria group (t=4.70～ 10.87,all P＜0.01).The positive rates of RBP,Cys C,β2-M and combined detection of RBP,Cys C and β2-M in micro proteinuria group and massive proteinuria group were significantly higher than those in control group and simple diabetic group (x2 =20.27～38.57,all P＜0.01).There was no significant difference in the positive rates between micro proteinuria group and massive proteinuria group (x2 =0.62～0.93,all P＞0.05).The positive rate of combined detection of the three indicators was higher than that of the single detection in the same group (x2=3.97～6.65,P＜0.05 or P＜0.01).Conclusion The detection of serum Cys C,RBP and β2-M has a high clinical value in the diagnosis of early renal damage in patients with GDM.The positive rate of combined detection of 3 indexes was higher than that of single index.

Objective To study molecular adsorbent recycling system (MARS) in the treatment of patients with acute liver failure waiting for liver transplantation. Methods The effects of MARS artificial liver treatments in 16 cases were reviewed. Results There was a remarkable improvement in clinical symptoms and physical signs after MARS treatment, including significant decrease in prothrombin time, total bile acid, level of alanine aminotransferase, aspartate aminotransferase, creatinine, and blood ammonia (P＜0.05＝;There was no statistical change in NO,TNF-α and IL-10(P＞0.05).Sequential organ failure assessment(SOFA)score decreased from 9.91±1.09 to 6.64±1.76 and Glascow coma score increased from 7.29±2.06 to 13.26±2.14.Fourteen patients were tided over to liver transplantation among them 13 patients survived and were successfully discharged from the hospital. The survival rate was 89.5%.Conclusion MARS is a safe and effective assistant device in bridging acute liver failure patients to liver transplantation.

Objective:To investigate the clinical characteristics and related factors of patients with chronic obstructive pulmonary disease (COPD) complicated by obstructive sleep apnea (OSA).Methods:The clinical data of 153 patients with COPD who received treatment in Xiangyang First People's Hospital from July 2018 to December 2019 were retrospectively analyzed. A total of 101 patients with complete data regarding pulmonary function and polysomnography who met inclusion criteria were selected. They were divided into simple COPD (COPD group, n = 33) and COPD + OSA (OS group, n = 68) groups according to whether they developed OSA. General clinical data, pulmonary function indexes and polysomnography indexes were compared between the COPD and OS groups. Logistic regression analysis was performed to analyze the degree of airflow limitation and the related factors of COPD combined with OSA. Results:There were more males than females in each group. In the OS group, the proportion of males, body mass index, forced expiratory volume in one second (FEV 1), forced expiratory volume in 1 second percent predicted (FEV 1%pred), the ratio of FEV 1 to forced vital capacity (FVC), apnea-hypopnea index and oxygen desaturation index in the OS group were 92.6%, 24.0 (23.4, 24.8) kg/m 2, 1.2 (1.2, 1.5) L, 50.0 (49.6, 59.4)%, 49.1 (46.9, 53.0)%, 15.4 (16.4, 25.3) times/h, 14.8 (17.3, 25.6) times/h, respectively, which were significantly higher than those in the COPD group [75.8%, 23.0 (21.6, 23.7) kg/m 2, 0.9 (0.9, 1.1) L, 41.0 (38.3, 49.1) %, 41.9 (39.5, 49.24)%, 1.9 (1.6, 2.4) times/h, 4.0 (3.7, 9.7) times/h, t or U = 4.246, 1 399.000, 1 544.500, 1 483.000, 1 407.000, 2 244.000, 1 915.000, all P < 0.05]. The lowest oxygen saturation at night in the OS group was significantly lower than that in the COPD group [81.5 (79.4, 82.6) % vs. 87.0 (80.2, 86.6) %, U = 758.500, P < 0.05]. There were no significant differences in age, smoking index and forced vital capacity between COPD and OS groups ( t = - 0.963, 1 150.000, - 1.954, all P > 0.05). Correlation and Logistic regression analysis revealed that the risk of severe or very severe airflow limitation was lower in the OS group than in the COPD group ( OR = 0.392, P < 0.05). BMI, FEV 1, FEV 1%pred were the risk factors of COPD combined with OSA ( OR = 1.185, 5.554, 1.034, all P < 0.05). BMI and FEV 1 were the independent risk factors of COPD combined with OSA ( OR = 1.168, 5.248, both P < 0.05). Conclusion:COPD and OSA are more common in males and in patients with higher BMI. OSA patients tend to develop lower degree of airflow limitation and more severe hypoxemia and apnea-hypopnea at night than COPD patients. Apnea-hypopnea index is the protective factor against airflow limitation in COPD. BMI, FEV 1 and FEV 1%pred are the risk factors of COPD combined with OSA. BMI and FEV 1 are the independent risk factors of COPD combined with OSA.

Objective:To study the interaction of the inflammatory cytokines expression between CD4+ T cells and primary human umbilical vein endothelial cells (HUVECs) infected by dengue virus (DENV-2).Methods:PBMC was extracted from white blood cells by density gradient centrifugation,CD4+ T cells were sorted by immunomagnetic beads.The expression of CD3 and CD4 molecules on the surface of cells was detected by flow cytometry to identify the purity of CD4+ T cells.First,HUVECs were pretreated by specific-S1 P1 receptor agonist CYM-5442 for 24 h,second,infected by DENV-2 on the titer of 103 TCID50,then co-culturing with CD4+ T cells,The relative expression of NS1 partial sequence and IL-6,L-8 mRNA of HUVECs,and IL-4,IL-17,TNF-α,IFN-γ of CD4+ T cells detected by Real-time RT-PCR.IL-6 and IL-8 secreted in cultured supematant analyzed by ELISA.Results:The purity of CD4+ T cells was (98.02±0.32) ％.The expression of NS1 gradually increased to 24 h (3.03±0.26,P＜0.001),decreased after reaching the peak.The relative expression of NS1 in the group of co-cultured with CD4+ T cells was lower than other groups.After infection,the expression of IL-6 and IL-8 were up-regulated,and the expression of IL-6 and IL-8 at each time point was significantly increased after co-culturing with CD4+ T (P＜0.01).IL-6 of CYM-5442 pretreatment group,in 24 h (28.91±2.34,P＜0.05),36 h(19.36±0.1,P＜ 0.05) and 72 h(13.84±0.82,P＜0.05) was significantly decreased,the expression of IL-8 also decreased significantly.The mRNA expression of IL-4,IL-17,TNF-α and IFN-γ in CD4+ T cells was significantly increased after co-culturing with HUVECs.After the treatment with CYM-5442 group,the expression was decreased.Conclusion:DENV-2 could infect the primary HUVECs,and the expression of NS1 was inhibited after co-culturing with CD4+ T cells.CD4+ T cells can not only enhance the activation of HUVECs infected by DENV-2,but also can be activated by the infected HUVECs infected with DENV-2.

ObjectiveTo observe the effect of immunoloregulation induced by tripterygium glycosides on experimental IgA nephropathy in rats.MethodsRat model of IgA nephropathy was established with bovine serum albumin and staphylococcal enterotoxins compound immunization.The urine erythrocyte,urine protein in 24 h,renal function,erythrocyte C3b receptor rosette rate and kidney constitution pathology alteration among the normal control group,model group and tripterygium glycosides group were compared.ResultsCompared with the model group,urine erythrocyte,urine protein,serum Cr and BUN reduced( P<0.05),erythrocyte C3b receptor rosette rate was higher(P<0.05),IgA depositing on glomerular mesangial region was less and renal function improved in rats of the tripterygium glycosides group.ConclusionTripterygium glycosides have better therapeutic effect and adjusting action for immune disturbance.