ObjectiveTo compare the different efficacy between invasive positive pressure ventilation andnoninvasivepositivepressureventilationofacuteexacerbationchronicobstructivepulmonary disease.Methods Patients with acute exacerbation chronic obstructive pulmonary disease were randomly divided into invasive positive pressure mechanical ventilation ( IPPV ) group ( n =35 ) and noninvasive positive pressure mechanical ventilation (NPPV)group (n =37 ),and clinical data before and after treatment were analyzed retrospectively.ResultsAfter 2 hours of invasive positive pressure mechanical ventilation,pH,arterial oxygen partial pressure( PaO2 ),arterial carbon dioxide partial pressure ( PaCO2 ),heart rate ( HR ),respiratory rate(RR),Glasgow coma scale(GCS) score were better than those before treatment[ pH:(7.35 ± 0.05)vs ( 7.23 ± 0.02 ) ; PaO2:( 92.4 ± 14.5 ) mm Hg vs ( 51.3 ± 9.4 ) mm Hg; PaCO2:( 56.0 ± 7.7 ) mm Hg vs( 82.6 ±8.1)mm Hg;GCS:(10.5 ± 1.1)points vs(8.5 ± 1.2)points;HR:(110 ± 12) times/min vs(131 ± 19) times/min ; RR:( 26 ± 4) times/min vs ( 35 ± 8 ) times/min ; P ＜ 0.05 or P ＜ 0.01 ].But in NPPV group,only the PaO2,HR,RR were better than those before treatment [ PaO2:( 78.6 ± 8.8 )mm Hg vs ( 53.1 ± 8.9 ) mm Hg; HR:( 110 ± 24) times/min vs ( 128 ± 23 ) times/min ; RR:( 26 ± 5 ) times/min vs ( 36 ± 9 ) times/min; P ＜ 0.05 ].And after 6 hours,pH,PaCO2,GCS score were significantly better in NPPV group [ pH:( 7.35 ± 0.03 ) vs ( 7.25 ±0.01 ) ;PaCO2:(59.0 ±6.3) mm Hg vs(79.8 ±7.0) mm Hg;GCS:( 10.6 ± 2.0) points vs( 8.5 ±2.5) points;P ＜ 0.05 or P ＜ 0.01 ].There was no difference on the days in ICU [ ( 15 ± 4) d vs ( 14 ± 4 ) d,t =1.102,P ＞0.05 ],the duration of mechanical ventilation[ ( 168 ± 25 )d vs( 170 ± 23 )d,t =1.214,P ＞ 0.05 ],the mortality in ICU (22.8％ (8/28) vs 21.6％ (8/37),x2 =0.016,P ＞ 0.05) between IPPV group and NPPV group.ConclusionIPPV can improve the situation of AECOPD quickly,but in NPPV group some patients need intubation.However,there was no significant difference on the days in ICU,the duration of mechanical ventilation,the mortality in ICU between IPPV and NPPV.

Objective To investigate the influence of atorvastatin on tumor necrosis factor - α (TNF- α) of sepsis rats.Methods Sepsis models were established using male SD rats by cecal ligation and puncture (CLP).A total of 100 healthy rats were divided into 4 groups ( n =25) randomly ( random number):sham- operation group,CLP group,low- dose atorvastatin group and high -dose Atorvastatin group.Blood samples of 5 rats in each group were collected at postoperative 0,3,6,12 and 24 hours,to detect tumor necrosis factor - α (TNF - α) levels in plasma.Observe and compare the mobility of rats in each group and specimens of small intestine were taken for histopathological examination by optical microscope.Results At 0 hour,plasmic TNF - α levels in 4 groups were statistically equal (P ＞ 0.05 ).In plasma of sham - operation group,changes of TNF - α levels were not obvious.Compared with CLP group,TNF - α levels in low - dose and high - dose Atorvastatin groups were both significantly lower ( P ＜0.01 ) at postoperative 3,6,12 and 24 hours.And TNF-α levels in high -dose Atorvastatin group were significantly lower than those in low - dose group ( P ＜ 0.01 ) at the 4 time points.The mortality of sepsis was higher in CLP model group than other groups,That of Atorvastatin group was significantly lower than CLP model group but higher than control group and high - dose group was lower than low - dose group.Conclusions Atorvastatin can inhibit the expression of TNF - α in blood plasma of sepsis rats and reduce inflammatory reaction.