Objective To evaluate the effect of de-escalation therapy of antimicrobial agents on the treatment of ventilator assoeiated pneumnonia(VAP).Methods 40 VAP patients were evaluated.17 cases were treated by de-escalation therapy of antimicrobial agents,the rest were treated by routine therapy.Results The achievement ratio of machine removing was superiorer to that of routine therapy(P1 week) received de-escalation therapy of antimicrobial agents whose average duration of ventilation was shorter than that treated by routine therapy(P

Objective To explore the effects of resistance exercise on intradialytic blood pressure variability and the lowest blood pres-sure. Methods From September, 2015 to March, 2016, 80 patients with intradialytic hypotension frequently during maintenance hemodialy-sis were included, and divided into control group (n=40) and intervention group (n=40) by drawing lots. Both groups accepted routine nurs-ing, while the intervention group accepted resistance exercise during hemodialysis. The coefficient of variation (CV) of blood pressure and the lowest blood pressure were compared twelve weeks later. Results The CV of systolic blood pressure was less in the intervention group than in the control group (t=-4.356, P<0.001), while the lowest blood pressure, both systolic and diastolic, were more (t>4.122, P<0.001). Conclusion Resistance exercise may reduce the intradialytic systolic blood pressure variability and increase the lowest blood pressure in pa-tients with frequent intradialytic hypotension.

In recent years the incidence of acute kidney injury (AKI) has increased, with a high mortality rate and poor prognosis.The key of improving the prognosis of AKI is early diagnosis and intervention.Due to the lack of biomarkers of early diagnosis in AKI, the effective early treatment is generally delayed.Traditional diagnosis biomarkers such as serum creatinine and blood urea are delayed and affected by various factors.Recently, some new potential early diagnostic biomarkers have been found.MicroRNA(hereinafter referred to as the miRNA) is a kind of endogenous non-coding small RNA, and studies have shown that it is related to the development of AKI.

Warfarin is widely used as one of the coumarins anticoagulation drugs in the clinical.Every physician has been disturbed by its narrow therapic index and bleeding complications.It is a difficult thing for the doctor to use it rationally.However,recently,with the rapid development of molecule biology,some research find that gene polymorphism of pharmacodynamics and pharmacokinetics cause the individual variability in drug response.In this review,we focus on the latest development in pharmacogenomics of warfarin at home and abroad in order to give some suggestions for the individual use of warfarin.

Functional experiment plays an important role in basic theory and clinical practice. For training high-quality medical talents in medical colleges,many improvements have been made in the functional experiment teaching and certain effects have been obtained. But a comprehensive evalu-ation system was still needed. Clinical medical students of 2010 grade were taken as the appraisal objects. Assessment content,methods and standards were designed according to the basic requirements of functional experiment. Students were evaluated by ordinary performance,test papers and experiment competition. Practice showed that the system was of significant importance in improving the experi-mental teaching quality and developing students' practical ability and comprehensive quality.

Objective To investigate the effects of orexin-A on learning and memory of pentyleneterazol (PTZ)-kindled epileptic rats.Methods Adult Wistar rats were randomly divided into control group(normal saline,NS)and PTZ group.The PTZ-kindled rats were randomly divided into,orexin-A group and NS group administrated by intracerebroventricular(i.c.v.)injection of 10μl orexin-A(1.4 nmol/μl)or 10μl NS.Using Morris water msze experiment,the ability of learning and memory was measured in all rats.Results Eighty percent of rats in PIZ group were kindled successfully after intraperitoneal injection of 35mg/kg PTZ every day for 30 days.Compared to control group,the escape latency in the PTZ-kindled rats was significantly increased in place navigation test(PNT)(F=200.956,P<0.01),whereas a remarkable reduction of time spent in the target quadrant and number of pool circlings in 120 seconds Was observed during probe trials.Following injection of orexin-A,the latency of escape platform was significantly declined in both PTZ-kindled((39.73±2.03)8,(33.76±2.96)s)and NS rats,increased the number of crossing the platform(10.83±1.80)vs(4.67±3.34).In addition,the treatment with orexin-A markedly increased swim velocity and number of pool circlings in beth groups(P<0.01),particularly to the PTZ-kindled rats.Conclusion Spatial learning and memory in the PIZ-kindled rats can be improved by treatment with orexin-A.

目的探讨急性心肌梗死(AMI)患者实施早期康复护理的效果。方法对86例AMI患者根据住院日期分为对照组和实验组,分别采用传统护理方式和早期康复护理方案实施护理,并进行效果比较。结果两组在心功能、心绞痛、心理状态、并发症、平均步行距离、住院时间等方面均有显著性差异(P<0.05或P<0.01)。结论实施早期康复护理效果优于传统护理方法。

Antiphospholipid syndrome(APS) is a autoimmune system disorder caused by thrombosis and is usually accompanied with persistent positive. Antiphospholipid antibodies profiles(aPLs) is the key to diagnosing APS. The most frequently detectable aPLs in current clinical applications are anticardiolipin antibodies (aCL), anti-β2 glycoprotein Ⅰantibodies (anti-β2 GPI), and lupus anticoagulant (LA).However, it is found that the current laboratory diagnostic standard for APS based on these three aPL have many defects. The standard can′t meet the clinical needs. In this article, the research and development of antiphospholipid antibody in recent years are summarized, and the clinical value of non-classified standard antibodies such as IgA antibody isotype and anti-domain 1 β2-glycoprotein I antibody are reviewed.

This study was aimed to optimize optimum preparation process of 5,7,3',4'-O-tetramethylquercetin (TMQ). With 5,7,3',4'-O-tetramethylrutin as raw material, TMQ was prepared by acidic aqueous solution method. The preparation process of TMQ was optimized by single factor test and orthogonal test. The results showed that the optimum technology conditions were ethanol concentration at 0, temperature at 80℃, hydrochloric acid concentration at 0.50%, and the hydrolysis time for 1.0 h. It was concluded that the optimum preparation process had the charac-teristics of high yield, simple process, stable and feasible.