The patients with cor pulmonale in release stage have been treated and cared with many methods.The results showed that there are obvious recuperatio of respiratory symptoms and lung function and evident strength of the immune function of the body and movement of diaphragm in the patients of treatment group with cor pulmonale compared with control group.The studies suggested that the rehabilitation treatment and care plays an important role in treating patients with cor pulmonale,particularly postponing and prevention acute attack.

Objective To investigate the expression and its clinical significance of serum urotensin Ⅱ(UⅡ)and nitric oxide(NO)in chronic cor pulmonale patients in acute exacerbation.Methods Totally 55 cases of chronic cor pulmonale in acute exacerbation(chronic cor pulmonale group)from Respiratory Department of First Affiliated Hospital of Jiamusi University during Nov.2006 to Mar.2007 and 40 healthy volunteers(normal control group)were collected.The levels of serum UⅡ and NO were detected in 55 cases of chronic cor pulmonale in acute exacerbation and 40 normal controls respectively.The condition of everyone's smoking history was collected.Arterial blood gas analysis was made in 37 cases of chronic cor pulmonale in acute exacerbation.The relationship among the levels of serum UⅡ,NO and PaO2,PaCO2,smoking history was observed.Results The levels of serum UⅡ and NO in chronic cor pulmonale in acute exacerbation were significantly higher than those of normal control group(all P

ObjectiveTo study the types of anatomical variations of hepatic arteries. Methods Hepatic arteries of 64-slice spiral CT scanning data were three-dimensional constructed by using self-designed software. The types of anatomical variations were analyzed and classified with Michels' classification criteria. Results The model presented with realistic profile of hepatic arteries which allowed vivid three-dimensional observation. Of these patients, 40 had normal hepatic arteries (60.61%), 26 had variations (39.39%), and 5 had infrequent aberrant hepatic arteries that was not included in Michels' classification (7.58%). Conclusion Three-dimensional model of hepatic arteries can volumetricly display the anatomical variations of hepatic arteries.

Objective To investigate the effect of tamoxifen (TAM) on the invasiveness of breast cancer SK-BR-3 cells and its mechanism.Methods The SK-BR-3 breast cancer cells in logarithmic growth period were cultured for 24 h by theserum-free RPMI 1640 culture medium,and then were divided into control group (serumfree RPMI 1640 medium) and TAM group(serum-freeRPMI 16400.5,2.5,12.5 mol·L-1TAM).Western blot was used to detect matrix metalloproteinase-9 (MMP-9),matrix metalloproteinase-2 (MMP-2),and vascular endothelial growth factor (VEGF) in groups.Scratch and transwelhests were used to detect the invasiveness of SK-BR-3 cells.Results The results of scratch test and Transwell experiment showed that the relative invasive ability of SKM-BR-3 cells in TAM (0.5,2.5,12.5 mol/L) group was significantly higher than that in the control group,and the difference was statistically significant (P＜0.05).The invasive ability of SK-BR-3 cells increased with the increase of TAM con centration.The results of Western blot showed that the expression levels of VEGF,MMP-9 and MMP-2 in SK-BR-3 cells of TAM group were average.It was significantly higher than the control group,and the expression levels of VEGF,MMP-9 and MMP-2 in SK-BR-3 cells increased gradually with the increase of TAM concentration.Conclusion Tamoxifen may play the role of estrogens and promote the invasiveness of SK-BR-3 breast cancer cells,via increasing the expression levels of VEGF,MMP-9 and MMP-2.

Objective To investigate the expression and clinical significance of IL-27 and TGF-β1 in patients with pulmonary fibrosis. Methods The expression levels of IL-27 and LTB4 were determined by ELISA method in 20 cases of pulmonary fibrosis patients and 15 cases of healthy control group. Results(1)The levels of IL-27 and TGF-β1 in pul-monary fibrosis patients were higher than the control group;IL-27 and TGF-β1 levels were gradually increased from the control group, pulmonary fibrosis mild hypoxia group, moderate hypoxia group, severe hypoxia group, the differences were statistically significant (F=21.58, P<0.001; F=18.75, P<0.001);(2)The serum IL-27 and TGF-β1 levels were significantly reduced with the increase of PaO2, the linear correlation was found between the two groups and PaO2 were negatively correlated(r=-0.754,P<0.05;r=-0.793,P<0.05);It was positively correlated between IL-27 and TGF-β1(r=0.854,P<0.05). Conclusion IL-27 and TGF-β1 were being involved in the pathogenesis of pulmonary fibrosis, detec-tion simultaneously, there were important significances for pulmonary fibrosis clinic diagnosis and therapy.

Objective:To explore the influence of hypophosphatemia on weaning from mechanical ventilation.Methods:An observational study was conducted. The medical records of 30 mechanical ventilated patients with hypophosphatemia admitted to intensive care unit of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2018 to August 2020 were analyzed; another 60 mechanical ventilated patients with normophosphatemia around the same time were enrolled as controls by 1∶2 case-control matching based on gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score. And then the duration of invasive mechanical ventilation, times of spontaneous breathing trial (SBT), the diaphragmatic ultrasonography movement indexes, and outcome of weaning and prognosis during hospitalization were compared between the two groups. Receiver operator characteristic curve (ROC curve) was plotted to calculate the areas under ROC curve (AUC) and cut-off values of serum phosphorus for successful weaning and hospital survival. The correlations between the diaphragmatic ultrasonography movement indexes and serum phosphorus were analyzed by Pearson partial correlation analysis.Results:Compared with normophosphatemic group, the duration of invasive mechanical ventilation in hypophosphatemia group was significantly longer [days: 13.0 (7.0, 22.0) vs. 10.0 (5.5, 14.0), P < 0.05], and SBT attempts were more often [times: 3 (0, 5) vs. 1 (1, 2), P < 0.01], while the rate of successful weaning was lower (53.3% vs. 91.7%, P < 0.01), and the hospital mortality was higher (20.0% vs. 1.7%, P < 0.01). ROC curve analysis showed that serum phosphorus could predict successful weaning of mechanical ventilated patients, the AUC was 0.795, and the optimum cut-off value of serum phosphorus was 0.85 mmol/L with sensitivity of 73.2% and specificity of 84.2%. Serum phosphorus could predict hospital survival of mechanical ventilated patients, the AUC was 0.782, and the optimum cut-off value of serum phosphorus was 0.48 mmol/L with sensitivity of 81.9% and specificity of 85.7%. Compared with normophosphatemic group, diaphragm thickness at the end of inspiration (DTei), diaphragm thickness at the end of expiration (DTee), diaphragm thickening fraction (DTF), diaphragm excursion (DE) in hypophosphatemia group were all significantly decreased [DTei (cm): 0.19±0.07 vs. 0.27±0.08, DTee (cm): 0.14±0.05 vs. 0.19±0.06, DTF: (33.55±16.17)% vs. (45.04±18.66)%, DE (cm): 1.17±0.49 vs. 2.28±0.69, all P < 0.01]. Pearson partial correlation analysis showed that linear correlations were found between serum phosphorus and DTei, DTee, DTF, DE ( r values were 0.442, 0.351, 0.293, 0.628 respectively, all P < 0.01). Conclusions:Serum phosphorus may have correlation with the diaphragmatic ultrasonography movement indexes. Hypophosphatemia may impair the contractile properties of diaphragm, induce more SBT attempts and longer duration of invasive mechanical ventilation, and affect outcome of weaning and prognosis.

Objective To systematically retrieve,evaluate and integrate the best evidences on the early fluid resuscitation management in the patients with acute pancreatitis(AP)at home and abroad to provide ref-erence for clinical decision.Methods The related evidences on the early fluid resuscitation management in the AP patients were retrieved by computer from the databases of BMJ Best Practice,Up To Date,JBI,National Institute for Health and Care Excellence,Registered Nurses Association of Ontario,Guideline International Network,Scottish Intercollegiate Guidelines Network,International Association of Pancreatology,American Pancreatic Association,American College of Gastroenterology,Yimaitong,Cochrane Library,PubMed,Em-bass,CINAHL,The Web of Science,CNKI,Wanfang databases.The retrieval time limit was from the data-base establishment to March 20,2022.The literatures types included thematic evidence summarization,guide-lines,evidence summaries,systematic reviews and expert consensus.The researchers conducted the literature quality evaluation.The literatures meeting the standard conducted the evidence extraction.Results A total of 13 arti-cles were included,including 3 special subject evidence summary,4 guidelines,2 evidence summary,2 systematic evalu-ation and 2 expert consensus.A total of 16 pieces of best evidence were integrated,involving 4 aspects of organization management,evaluation and monitoring,fluid infusion strategy and health education.Conclusion It is recommended to use the target-oriented therapy for early fluid resuscitation management,and perform the fluid resuscitation immediate-ly after diagnosis,according to the patient's underlying disease,disease changes and monitoring indicators,implement precise early fluid resuscitation in order to reverse pancreatic microcirculation disorder,increase tissue perfusion and improve the patient's prognosis.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.