Objective To discuss the influence of respiratory training and prompting effective discharging of sputum for chronic obstructive pulmonary disease (COPD) patients in acute aggravation period. Methods 50 patients were randomized into the intervention group and the control group with 25 cases in each group.The intervention group received respiratory training and prompting effective discharging of sputum while the control was only given routine treatment and nursing.The ratio of first second expiration volume to forced vital capacity, oxygen partial pressure (PaO2),carben dioxide partial pressure (PaCO2) ,blood oxygen saturation (SpO2)and the in-hospital days were compared between the two groups. Results The clinical effect in the intervention group was superior to that of the control group with shorter in-hospital days (P<0.01).Conclusion Better results could be obtained by application of respiratory training and prompting effective discharging of sputum for COPD patients in acute aggravation period.

BACKGROUND: It has confirmed that angiotensin converting enzyme inhibitor benazepril can delay fibrosis of varied organs. However, whether benazepril has inhabited effect on peritoneal fibrosis in the process of peritoneal dialysis is poorly understood. OBJECTIVE: It is assumed that benazepril could inhabit peritoneal fibrosis of peritoneum with peritoneal dialysis, in addition, to compare the effect to other mehods. METHODS: All rats were randomly and evenly divided into 4 groups. There was no intervention in the control group; saline solution, and 20 mL 42.5 g/L Dianeal solution, was injected into rats in the saline solution and peritoneal dialysis groups; in the combination group, 20 mL 42.5 g/L Dianeal solution was injected combined with oral taken benazepril 20 mg/(kg·d). The intraperitoneal injection performed once a day, for 4 successive weeks. The ultrafiltration function was performed 4 weeks later. Meantime, Paraffin sections were cut and stained by Van Gieson to measure peritoneal thickness. RESULTS AND CONCLUSION: Two rats in the peritoneal dialysis group and 1 rat in the combination group were dead. The remained 37 rats were included in the final analysis. Compared to the control and saline solution groups, the ultrafiltration volume of the peritoneal dialysis and combination groups were obviously decreased (P_(all)< 0.05), especially notably decreased in the combination group (P< 0.05). Compared to the control group end saline solution groups, the peritoneal thickness was significantly elevated in the combination group, but not as much as in the peritoneal dialysis group (P < 0.05). In the long-term peritoneal dialysis rats, administration of benazepril can effectively protect the ultrofiltration function of peritoneum and delay the progression of peritoneal fibrosis.

Objective To determine postoperative resting energy expenditure ( REE) in children with congenital heart disease ( CHD) requiring open heart surgery , to compare measured resting energy expenditure (MREE) with current predictive equations (PEE), and to investigate the possible influencing factors on the metabolic status of the postoperative CHD children .Methods From February 2015 to June 2015 , 150 ventila-ted children admitted to the cardiac intensive care unit after surgery for congenital heart disease in Shanghai Children's Medical Center were enrolled consecutively .Indirect calorimetry ( IC) measurements were performed using metabolic cart 4 hours after surgery .General clinical data were recorded .Results Totally 104 male and 46 female patients were enrolled, with a median age of 14 months (8.3-36.0 months).The non-protein re-spiratory quotient of patient was 0.79 ±0.20, MREE was (264.76 ±61.74) kJ/(kg· d), and PEE using Schofield equations was (278.51 ±93.42) kJ/(kg· d).Although there was no significant differences (P=0.096 ) between MREE and PEE , the agreement was poor between them ( R2 =0.119 ) .Multivariate stepwise regression analysis showed that MREE had significant positive correlation with risk adjustment in congenital heart surgery (RACHS-1) score (P=0.012) and negative correlation with age (P=0.010).Up to 97.33%of children (146/150) had lower energy intake compared with MREE on the 1st postoperative day .Conclu-sions MREE does not increase after surgery in CHD children;however , the substrate utilization is influenced . Factors influencing the postoperative REE include RACHS-1 score and age.The energy intake at 1st day after surgery is generally lower than REE in these children .

Objective To assess the CT image quality of the pure ground glass nodule(pGGN)in chest phantom by using different field of view(FOV)and matrix.Methods CT(Philips Brilliance 128 spiral CT)scans were performed on chest phantom containing 9 artificial pGGNs(diameter≥5 mm)in 3 different FOV (50 mm,150 mm,300 mm ),and were reconstructed in 2 different matrix(512×512, 1 024×1 024),standard kernel.Recorded the CT values and standard deviations (SD)of the nodules and surrounding regions in different FOV and matrix,and calculated the mean standard deviation(MSD),contrast noise ratio (CNR)and signal noise ratio (SNR),then compared the difference among them.Two radiologists assessed the image quality of the pGGNs in blind method respectively,then evaluated the coherence between them using Kappa testing.Results The coherence of 2 observers was substantial or almost perfect.No significant differences were found on MSD,CNR and SNR in different FOV (P value>0.05)when matrix was kept,whereas the visibility of the nodules improved with the FOV changing smaller.And there were significant differences all on MSD,CNR and SNR by using different matrix when FOV was kept.The MSD increased and the CNR,SNR decreased in high-resolution group.The visibility of the pGGNs was not improved obviously in high-resolution group.Conclusion The image quality of the pGGN(diameter≥5 mm)won’t be changed by using smaller FOV when matrix is kept ,but the visibility will be improved with the FOV changing smaller.When FOV is kept,the MSD increased and the CNR,SNR reduced in high-resolution group,but the visibility will not be improved obviously compare to the standard resolution group.

Objective To study the change of Yes-associated protein (YAP) expression in rectal cancer and to explore the significance of YAP in rectal cancer.Methods Reverse transcriptase polymerase chain reaction(PT-PCR) and Western bloting technology were used to detect mRNA and protein expression of YAP in 30 patients with rectal cancer and 10 cases of normal rectal mucosa tissue.Results The expressions of mRNA and protein of YAP in rectal cancer were significantly higher than those in normal rectal mucosa tissue (73.2 ± 1 1.1 vs.10.4 ± 4.1,65.7 ± 9.5 vs.9.2 ± 4.3,P ＜ 0.05).Conclusion YAP high expression is related to the occurrence of rectal cancer.

Background and purpose: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new minimally invasive method in the dignosis for mediastinal lymph nodes. This study was to evaluate the diagnostic yield of EBUS-TBNA for mediastinal lymph nodes. Methods: Twenty patients with mediastinal lymph nodes found by CT underwent the dignosis by EBUS-TBNA form April 1st 2009 to July 16th 2009. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EBUS-TBNA were evaluated. Results: Twenty patients with 37 lymph node groups were studied. Overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of EBUS-TBNA for diagnostic were 84.62%, 100%, 100%, 77.78% and 90.00%, respectively. The diagnostic accuracy for cancer was 100%. The operation time was 11.9min per group in average with no serious complication. The median length of hospital stay was 1 (range from 1 to 17 days) day after operation. There were significant differences in the average operation time between the first three patients and the others (36.25 min vs. 7.76 min; z=3.247, P=0.001). Conclusion: Endobronchial ultrasound-guided transbronchial needle aspiration proved to be a safe procedure with a high yield for the diagnosis of mediastinal lymph nodes.

Objective To investigate mupiroein resistance in Staphylococcus aureus (SAU) and the resistance to commonly used antibiotics in mupirocin-resistant strains. Methods Four hundred and ninety clinically isolated SAU strains froin January 2005 to May 2007 in the First Affiliated Hospital,Wenzhou Medical College were screened by mupirocin(5μg)disc diffusion method.Minimum inhibition concentration(MIC)and the amplification of mupA gene were performed to determine the resistance to mupirocin.Resistance to cefoxitin,gentamycin, levofloxacin, trimethoprim/sulfamethoxazole, rifampin, erythromycin, clindamycin, tetracycline and vancomycin in mupirocin-resistant strains was detected by disc diffusion method, and the amplification of mecA gene was performed to confirm the methieillin resistance among mupiroein-resistant strains.Results Twenty-seven mupirocin-resistant strains were obtained,in which 22(81.5%)were hish-level mupirocin resistant(MuH)and the rest were low-level mupirocin resistant(MuL).Among 27 mupirocin-resistant strains,24 were methicillin-resistant Staphylococcus aureus (MRSA)in which 21 were MuH and 3 were MuL strains.Drug sensitivity tests showed that the resistance to gentamycin,levofloxacin,trimethoprim/sulfamethoxazole,rifampin,erythromycin,elindamycin and tetracycline were hish among MuH and MuL strains,and most of these strains were multi-drug resistant.All strains were susceptible to vaneomycin.Conclusions Most of the clinical emerged mupirocin-resistant SAU strains are MuH and show hish resistance to commonly used antibiotics.Therefore,detection and drug sensitivity test of mupirocin-resistant strains should be strengthened in clinic practice in order to prevent it from dissemination.

Objective To inVestigate the Potential mechanism and ProtectiVe effects of osthole on rats with focal cerebral ischemia_rePerfusion injury. Methods Middle cerebral artery occlusion was induced by the suture_occluded method. After 2 h of cerebral ischemia and 24 h of rePerfusion,scores of neurological deficits and infarct Volume were eValuated. The leVels of SOD,MDA,GSH and ATPase were also determined. Results Scores of neurological deficits and infarct Volume were lower in the osthole grouPs than in the model grouP. Meanwhile,the actiVity of SOD and GSH content were increased,while the MDA content was decreased in osthole grouPs. Conclusion Osthole exerts ProtectiVe effects on rats with focal cerebral ischemia_rePerfusion injury.

Objective To search one ultrasonic method which could evaluate gastric emptying function accurately.Methods The gastric emptying time of 74 normal volunteers were measured by radioisotope scanning and different ultrasonic methods which including gastric antrum area,gastric antrum volume and whole gastric cylinder method.Results The gastric emptying time measured by whole gastric cylinder method related best with those measured by radioisotope scanning (r =0.79).The gastric emptying time was no significant difference between the cylinder method and radionuclide scanning (P ＞0.05).Compared with radionuclide scanning,those measured by gastric antrum area and gastric antrum volume had significant differences.Conclusions The whole gastric cylinder method can accurately reflect the gastric emptying function.

Objective To evaluate the correlation between homologous recombination repair protein RAD51 and methotrexate-enhanced radiosensitivity.Methods Western blot and RT-PCR assays were used to detect RAD51 expression in HOS osteosarcoma cells exposed to γ-ray irradiation alone and in combination with methotrexate.Colony formation assay was used to test the survival fraction of HOS cells exposed to γ-rays and methotrexate.Results Methotrexate inhibited both protein and RNA expressions of RAD51,and the combination of radiation and methotrexate enhanced the inhibition of RAD51 expression.Moreover,transfection of cells with RAD51 gene decreased cellular sensitivity to methotrexate and γ-rays.The sensitizer enhancerment ratios after irradiation in combination with methotrexate were 1.51 and 0.99,respectively.Methotrenate was a preferred radiosensitizer to HOS cell.Conclusions RAD51 might be involved in the methotrexate-enhanced radiosensitivity.