Objective To explore 24-hour ambulatory blood pressure of patients with cervical spinal cord injury. Methods 42 patients with cervical spinal cord injury and 45 patients with thoracic-lumbar spinal cord injury were included. Their 24-hour ambulatory blood pressures were monitored. Their day systolic blood pressure (dSBP) and day diastolic blood pressure (dDBP) when seating and standing, night SBP and DBP, and SBP descending rate at night were compared. Results There were significant differences in dSBP and dDBP when standing, and SBP descending rate at night between 2 groups (P<0.01). There was significant difference in dSBP between seating and standing position in patients with cervical spinal cord injury (P<0.01). Conclusion There is orthostatic hypotension in cervical spinal cord injury patients and their SBP descending rate at night is upside down.

Objective To explore the ralationship between maternal serum level of soluble endoglin (sEng) in advanced gestations and hypertensive disorders comlicating pregnaney(HDCP). Methods The serum levels of sEng were analyzed using enzyme-linked immunosorbent assay (ELISA). Blood samples were obtained from 62 pregnant women with HDCP at 35-39 weeks' gestation (20 gestational hypertension, 20 mild preeclampsia, 19 severe preeclampsia and 3 eclampsia), and 20 normal pregnant women at 37-39 weeks' gestation (control). Results The serum sEng levels in normal, gestational hypertension, mild preeclampsia, severe preeclampsia and eclampsia group were (6.24±0. 26) ng/ml; (6. 56±0. 29) ng/ml; (7.47±0. 31) ng/ml; (8. 71± 0. 37) ng/ml and (9.69±0. 28) ng/ml, respectively. The serum sEng levels in the preeclampsia and eclampsia group were significantly higher than those in the gestational hypertension and normal group (P<0. 01), that of the severe preeclampsia group was significantly higher than the mild preeclampsia (P<0. 01), and that of the eclampsia group was significantly higher than the preeclampsia group (P<0. 01). However, no difference was found between the gestational hypertension and normal group (P>0. 05). Conclusions The increased serum level of sEng may participate in the genesis of HDCP.

ObjectiveTo investigate the effect on improving immune function by hemofiltration combined with hemoabsorption in septic patients with low human leukocyte antigen DR (HLA-DR) expression.Methods A prospective randomized controlled trial was conducted. Sixty sepsis patients aged over 18 years, with HLA-DR expression lower than 30% were enrolled, and they were randomly divided into experimental group and control group, n = 30 in each group. The patients were treated with standard operating procedure for sepsis, and hemofiltration combined with hemoabsorption were added in addition in the experimental group within 1-3 days. The continuous veno-venous hemofiltration (CVVH) mode was performed, with former dilution volume 4 L/h, and the hemofilter HF2000 was carried out with blood absorber HA-330H. The expression of HLA-DR in peripheral blood mononuclear cells was determined before the treatment and 3, 5, 7 days after treatment. Acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, duration of mechanical ventilation, length of intensive care unit (ICU) stay, and 28-day survival rate were evaluated in both groups.Results The HLA-DR expression before treatment in experimental group and control group was both lower than 30%, and there was no statistical difference [(25.9±7.3)% vs. (26.4±6.7)%,P>0.05]. The HLA-DR expression at 3, 5, 7 days after treatment in experimental group was gradually increased, and it was significantly higher than that of the control group [3 days: (38.9±8.6)% vs. (29.3±7.1)%, 5 days: (42.7±9.2)%vs. (31.4±6.5)%, 7 days: (40.9±8.5)% vs. (29.4±6.7)%, allP< 0.05]. There was no significant difference in APACHEⅡ score before treatment between experimental group and control group (22.4±5.3 vs. 21.7±6.2,P>0.05). APACHEⅡ score at 3, 5, and 7 days after treatment was gradually decreased in experimental group, and it was obviously lower than that of the control group (3 days: 18.6±3.6 vs. 20.5±4.3, 5 days: 15.8±3.9 vs. 21.1±4.4, 7 days: 14.9±4.2 vs. 19.8±3.7, allP< 0.05). Compared with the control group, the duration of mechanical ventilation (days: 13.3±3.4 vs. 19.8±3.7,t = 6.432,P = 0.003) and length of ICU stay (days: 20.7±3.9 vs. 26.8±4.7,t = 5.452, P = 0.006) in experimental group were significantly shortened, and the 28-day survival rate was significantly elevated (83.3% vs. 73.3%,χ2 = 3.121,P = 0.016).Conclusion Hemofiltration combined with hemoabsorption can improve the expression of HLA-DR in sepsis patients with low expression of HLA-DR, and it can improve immune function and prognosis of sepsis patients in certain degree.

Objective To investigate the effect of outpatient nursing intervention in patients with chronic rhinosinusitis(CRS)on the aspects of clinical efficacy, quality of life and nursing satisfaction after medical therapy. Methods The clinical efficacy according to the judgment standard for clinical effect was valued. Medical outcome study short-form 36-items health survey (SF-36) was used to assess the quali?ty of life of the subjects. Satisfaction Questionnaire was used to evaluate the satisfaction scale of patients. Eighty subjects with CRS were randomly divided into the control group (40 cases) and the trial group (40 cases). The trial group was given nursing intervention on basis of usual nursing. In three months after treat?ment, the data and statistics analysis was purely descriptive by SPSS 20.0. Results Clinical efficacy:in the group, nineteen subjects were cured,fourteen subjects were improved and inefficacy occurred in seven subjects. The effective rate was 77.5%(31/40). In the trial group, twenty-six subjects were cured,twelve subjects were improved and inefficacy occurred in two subjects. The effective rate was 95.0%(38/40). There were differences in general data between the two groups (χ2=5.165,P=0.023). Quality of life:the average score of the control group was 58.10±5.04, while the average score of the trial group was 72.22±5.63, the average score of quality of life in the trial group was significantly higher than that in the control group(t=3.08,P=0.025). Nursing satisfaction:there were significant differences in nursing satisfaction between the control group and the trial group (u=-7.048,P=0.000). Conclusions Outpatient nursing intervention can improve the effect of patients with chronic nasal sinusitis after medical therapy, improve the quality of life and improve nursing satisfaction.

Objective To explore the clinical features and treatment of polycythemia vera(PV)complicating stroke.Methods Clinical data of 27 cases of PV complicating stroke were analysed retrospectively.Results(1)Among all the cases,PV complicating cerebral infarction were 22 cases(81.5%),among the 22 cases,18 cases(66.7%)of multiple cerebral infarction,2 cases(7.4%)of transient ischemic attack,2 cases(7.4%)of cerebral hemorrhage,1 case(3.7%)of subarachnoid hemorrhage(SAH).The patients's clinical manifestation,physical sign,hemogram,marrow characteristic were consistent with that of PV diagnosis criteria.(2)Imageology check show that small infarction focus were common(66.7%).Lobe of brain,basal ganglia,capsula interna were common place of cerebral infarction.The density of hemorrhagic focus was asymmetrical,there was obvious edema around the hemorrhagic focus.(3)Applied vein blood-letting and small dose chemotherapy,8 cases were recovery,18 cases were obviously improved,1 case of stroke was invalid.Conclusion The cerebral infarction are common in PV complicating stroke.Among all the PV complicating stroke cases,multiple cerebral infarction are the most common,cerebral hemorrhage and subarachnoid hemorrhage are few,vein blood-letting and small dose chemotherapy has a good curative effect for the patients.

Objective To investigate the clinical efficacy of combination therapy of ambroxol with vibration? expectoration machine on ventilator-associated pneumonia Methods A total of 96 patients from the Department of Critical Care Medicine were selected and randomly divided into 3 groups:control group,ambroxol group and ammonia ambroxol + vibration expectoration machine group (n=32,each).The ventilator-associated pneumonia (VAP) was randomly divided into three groups (n =32,each).All patients were treated with conventional therapy including anti-inflammatory,suction,airway humidification,nutritional support.On this basis,ambroxol group was given ambroxol 30 mg in 100 ml normal saline,intravenously dripped 3 times a day.On the basis of treatment in the ambroxol group,ammonia ambroxol + expectoration machine were given G5 vibration expectoration machine to expectorate sputum 2 times every other day.Results There were significant differences in acute physiology and chronic health evaluation (APACHE Ⅱ),PaO2/FiO2,respiratory rate (RR),heart rate (HR) before versus after the treatment of the three groups (F =5.736,9.432,6.361,5.862,respectively,all P＜0.05).After treatment in the three groups,APACHE Ⅱ,PaO2/FiO2,RR and HR showed statistically significant differences inter-group among three groups (F=4.674,8.665,7.351,6.562,respectively,all P＜0.05).Clinical effective rates of the three groups were 71.9％,84.4％,93.8％ respectively,and showed statistically significant differences inter-group among three groups (all P＜0.05).Conclusions Combination therapy of ambroxol and vibration expectoration machine shows significant effects on VAP,and it is better than ambroxol alone.

ObjectiveTo explore the clinical presentation, diagnosis, treatment, and outcome of the Barth syndrome (BTHS).MethodsClinical data were collected and analyzed from 3 patients with conifrmed genetic diagnosis of BTHS from June 2013 to October 2014.ResultsAll of the 3 patients were males and two of them were twins. The main clinical manifes-tations of the 3 patients were cardiomyopathy and heart failure, accompanied by different degrees of trabeculations of the left ventricle. Two of them were diagnosed of left ventricular noncompaction (LVNC). All of the 3 patients presented with motor retardation, muscle weakness, growth delay and signiifcantly increased urinary excretion of 3-methylglutaconic acid (3-MGC). One patient was found to have neutropenia. All 3 patients hadTAZ gene mutations which included a novel missense mutation (c.527A>G, p.H176R) detected in the twins and a known nonsense mutation (c.367C>T, p.R123X) identiifed in the other patient. All of the mutations were inherited from their mothers. During the follow-up, the twins died at 7 months old and 7.5 months old respectively. The other patient was still alive.ConclusionBTHS is one of the causes of cardiomyopathy in children. In the male patients who presented with muscle weakness, neutropenia, and increased urinary excretion of 3-MGC, especially in those com-bined with LVNC, BTHS should be screened.

Objective:To detect the interleukin-22(IL-22) levels in peripheral blood of the asthma patients and analyze the relationship between the IL-22 levels and IgE,pulmonary function,fractional exhaled nitric oxide(FENO),and to investigate the role of IL-22 in the pathogenesis of bronchial asthma. Methods:Seventy-eight patients with asthma were selected as experiment group.The asthma patients were divided into increased IgE group (n=46)and normal IgE group(n=32)according to the IgE levels.The asthma patients were also divided into acute attack stage and clinical control stage according to patients' clinical symptoms.In addition, twenty healthy controls were chosen as healthy control group.The plasma IL-22 levels, IgE,forced expiratory volume in one second (FEV1) and FENO levels of the subjects in various groups were detected and compared between various groups.The correlations between the plasma IL-22 levels and IgE, FEV1,FENO were analyzed.Results:The plasma IL-22 level and FENO level of the patients in asthma group were higher than those in healthy control group(P<0.05).The IL-22 level and FENO level of the patients in clinical control stage were lower than those in acute attack stage,but they were still higher than those in healthy control group(P<0.05).The plasma IL-22 level of the patients in increased IgE group was higher than that in normal IgE group(P<0.05).There were significant negative correlations between the IL-22 levels and FEV1 in the asthma patients in acute attack group and clinical control group(r=-0.365 3,P<0.05;r=-0.267 2,P<0.05),but there was no significant correlation between the IL-22 levels and FENO(r=0.011 9,P>0.05;r=0.059 8,P>0.05).Conclusion:The increased expression of IL-22 in peripheral blood of the patients with asthma may participate in the pathogenesis of asthma,and may aggravate the deterioration of pulmonary function of the asthma patients.

ObjectiveTo investigate the effects of budesonide inhaled on the levels of interleukin-8 (IL-8), C-reactive protein (CRP) and procalcitonin (PCT) in bronchoalveolar lavage fluid (BALF) of patients with AECOPD treated by using inhalation of budesonide in different doses or by using injection of dexamethasone. MethodsNinety AECOPD patients with mechanical ventilation in ICU ward were enrolled from Jan. 2008 through Sep. 2010. All patients were selected in this study as per the criteria of AECOPD set by the Chinese Medical Association. Ninety AECOPD patients treated with routine therapy were randomly (random number) divided into 3 groups. The patients of group A were given budesonide 2 mg inhaled 1 time/d. The patients of group B was given budesonide 4 mg inhaled 1 time/d. The patients of group C had dexamethasone 2. 5 mg injected 1 time/12h. The changes of IL-8, PCT and CRP in both BALF and serum were respectively detected in three groups at the beginning of treatment, and 3 days and 7days after treatment. The detected data of variables were analyzed by SPSS 13.0 package. ResultsThe level of IL-8 in BALF declined in 3days and 7days after treatment, and the magnitude of decrease in the following order:Group B ( budesonide 4mg/d) ＞ Group A ( budesonide 2 mg/d) ＞ Group C ( intravenous dexamethasone)with significant differences among them ( P ＜ 0. 05 ). The decrease in IL-8 in serum showed the similar trend, but there were no statistical differences among them. The CRP and PCT in both BALF and serum had no significant changes. There was a correlation between the concentration of IL-8 in BALF and the duration of mechanical ventilation.Conclusions The treatment with the inhalation of budesonide could more significantly reduced the IL-8 level in BALF compared with intravenous dexamethasone, whereas the CRP and PCT were not changed. The dynamic changes of IL-8 in BALF might be used as an indicator of prognosis in AECOPD patients with mechanical ventilation.