Objective To investigate the therapeutic efficacy of tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate in the treatment of acute exacerbation of chronic pulmonary heart disease.Methods A total of 148 cases of acute exacerbation of chronic pulmonary heart disease were divided into observation group (n =74) and control group (n =74).The observation group received tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate,while the control group was given meglumine adenosine cyclophosphate.Results Before treatment,the forced expiratory volume in one second(FEV1),forced vital capacity(FVC),arterial oxygen tension(PaO2),arterial carbon dioxide partial pressure(PaCO2) and pH of the observation group were no significant differences [(1.27 ±0.44)L vs (1.24 ±0.47)L,(2.49 ±0.74)L vs (2.43 ±0.77) L,(51.6 ±6.6) mmHg vs (51.2 ±6.7) mmHg,(69.1 ± 8.4) mmHg vs (69.5 ± 8.7) mmHg,7.27 ± 0.03 vs 7.26 ± 0.04,P ＞ 0.05].After treatment,The FEV1,FVC,PaO2,PaCO2 and pH were significant differences between the 2 groups[(1.45 ±0.39)L vs (1.31 ±0.41)L,(2.71 ±0.63)L vs (2.49 ±0.54)L,(72.8 ±5.3) mmHg vs (62.5 ±6.2)mmHg,(47.7±5.7)mmHgvs (56.2±7.2)mmHg,7.34±0.02 vs7.31±0.03,t =2.13,2.28,10.86,-12.65,7.16,P ＜0.05].Before treatment,the Ⅰ ～ Ⅳ NYHA cardiac functional grading were no significant differences between the 2 groups(0,17.6％,47.3％,35.1％ vs 0,18.9％,44.6％,36.5％,P ＞0.05).After treatment,theⅠ ～ Ⅳ NYHA cardiac functional grading of the observation group were 25.7％,44.6％,20.3％,9.4％ respectively,and the NYHA cardiac functional grading of the observation group was significantly better than that of the control group(20.3％,27.0％,36.5％,16.2％,t =2.27,P ＜0.05).Conclusions The tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate showed good therapeutic efficacy in the treatment of acute exacerbation of chronic pulmonary heart disease,and this combined treatment program is able to improve the heart and lung function simultaneously.

Objective To investigate a myocutaneous flap method for eyelid baggy plasty conforming to the medical aesthetic requirements. Methods Before operation the amount of the lower eyelid skin excised should be determined. Asking the patient to look upward at supine position, the operator lifted properly the lower eyelid skin using fine forceps without teeth at the results of smooth superficialness at this region and slight ectropion. The incision lines were marked along the print pinched by forceps and the trace 2 to 3 mm below the ciliary margin. Intra-operatively severing soft issues to the inferior orbital fringe just on the sub-orbicularis level, the skin-muscle flap was made. Then the excessive muscle was removed in the light of the incision lines. The orbital fat teased out resected or filled up the concavity along the lower orbital edge. Results The tense and smooth appearance of lower eyelid was archived in 900 cases received in our hospital except 2 temporary ectropion cases and 2 temporary double vision cases. We repaired the 15 ectropions using adjacent skin flap, tarsal reduction, skin soft tissue expansion, or superficial temporary fascia sling suspension, eliminated 28 haematomaes and made the excision of scar and wound suture for a hypertrophic scar case in the 150 complications from other hospitals. The crow wrinkles were improved apparently. Conclusion The amount of skin excision determined pre-operatively, which not only successfully refrains interfering elements from blooding and swelling but also avoids giving rise to ectropion, is accurate than that performed during operation. Natural appearance after operation becomes better and lasting because of orbicularis raised which strengthens the anterior wall of orbital septum.

Objective To study the clinical effects of abdominoplasty using ultrasound assisted liposuction and dermolipectomy. Methods With the patient standing, the relative areas of maximal adipose fullness in the abdomen and waist were marked topographically. With the patient in the supine position, the "pinch test" was performed by surgical operator advancing the tissue in the infraumbilical area toward the pubic region in order to estimate how much skin needed to be resected before operation. Inter-operatively tumescent technique with the transduction of ultrasound into fatty areas was applied in the first place, following classic abdominoplasty including excessive skin and fat resection, musculoaponeurotic plication and umbilical transposition. Results Sixteen patients followed up from six months to two years were satisfied with aesthetic effects because of smoothness of the operated areas, good sensory recovery and obvious shrinkage of skin with fewer complications. There were no infection, skin necrosis, and wound dehiscence. Conclusion The excellent effects of abdominal profile sculpture can be reproduced with the new method using UAL in vivo and dermolipectomy.

Objective To search for clinical appearance and fungal resistance of candidemia in ICU.Methods Thirty-four cases of candidemia in ICU during 2003and 2006 were analyzed retrospectively.Results Twelve of 34 cases of candidemia were C.albicans,and 22 of 34 cases were non-C.albicans,which were 64.71% in candida monilia.Fever and chill of candidemia were 100% and 70.59% differently.Conclusion If there is high risk factor of fungous infection in clinic,at the same time fever and chill appear,and antibiotics treat is inefficacy not effective,it is possible to consider candidemia.

Objective:To observe the effect of Pihui Sachet on influenza A and B virus.Methods:The Pihui Sachet and mice were put in the same sealed container,four days later,the mice were infected with influenza A and B virus,the survival rate and lung index of the mice were compared.Results:The Pihui Sachet could alleviate the pulmonary disease,decrease the lung index,reduce the death rate,prolong survival days of the mice infected with influenza A and B virus.Conclusion:The Pihui Sachet had antiviral effect on the influenza A and B virus.

Objective:To establish a method to determine the content of lidocaine hydrochloride in buccal adhesive tablets contai-ning carbomer as an excipient by HPLC. Methods:Calcium chloride was used to precipitate carbomer in buccal adhesive tablets. The HPLC analysis was performed on a Welch C18 column(250 mm × 4. 6 mm,5 μm)with the column temperature of 40℃. The mobile phase was the mixture of 0. 05% sodium acetate solution(added 50 ml acetic acid into 930 ml distilled water,adjusting pH to 3. 40 with 1 ml·min-1 sodium hydroxide solution)and acetonitrile(70:30). The flow rate was 1. 0 ml·min-1 ,the detection wavelength was at 254 nm and the injection volume was 20 μl. Results:Within the range of 0. 10-2. 00 mg·ml-1 ,there was a good linear rela-tionship between the concentration and the peak area of lidocaine hydrochloride(r=0. 999 9). The average recovery was 100. 2%( RSD=1. 4%,n=9). Conclusion:The established method is simple,accurate and reproducible,which can be applied to determine the content of lidocaine hydrochloride in buccal adhesive tablets.

Objective To evaluate serum cystatin C combined with dipstick proteinuria as early markers to predict AKI available before surgery.Methods We prospectively followed 616 patients undergoing cardiac surgery.Univariate as well as multivariate regression was performed.Cystatin C combined with dipstick proteinuria before surgery was assessed for its' predictive value of AKI using receiver operator characteristic (ROC) curves.Results Patients in higher cystatin C quartiles were older(P ＜ 0.001),more often to have heavy proteinuria(P =0.021),hyperuricemia(P ＜ 0.001),heart failure(P ＜ 0.001)and recent MI (P =0.002).Those with heavy proteinuria were more often to have diabetes mellitus (DM) (P =0.010),hyperuricemia (P =0.043),worse cardiac function (P ＜ 0.001),higher creatinine levels (P ＜ 0.001) and lower eGFR levels (P ＜0.001).In a multiple logistic regression model,preoperative heavy proteinuria(OR =3.14) and preoperative cystatin C quartiles each associated with an increased odds of AKI,independent of advanced age (OR =1.04),hypertension (OR =1.88) and combined surgery(OR =3.47).The risk for adverse outcomes such as postoperative AKI,persistent AKI,severe AKI,dialysis and mortality were highest in patients with highest quartile of cystatin C(P ＜0.05,respectively) and heavy proteinuria (P ＜ 0.05,respectively).The area under the ROC curve(AUCs) for preoperative cystatin C combined with proteinuria to detect AKI,persistent AKI and severe AKI were 0.695,0.753 and 0.718,P ＜0.001 respectively.Conclusion These data suggest that preoperative serum cystatin C combined with dipstick proteinuria may improve prediction of AKI among patients undergoing cardiac surgery.

AIM: To investigate the cardioprotective effects of monophosphoryl lipid A(MLA) and its molecular mechanisms.METHODS: In the ischemia/reperfusion(I/R) model of porcine hearts, the effect of MLA on myocardial infarct size was observed. The protein levels of extracellular signal regulatory kinases (ERKs) and heat shock protein (HSP) 86 were detected by using western blotting method. RESULTS: MLA pretreatment significantly limited the infarct size in the porcine hearts subjected to I/R. It is also found that MLA pretreatment upregulated the protein levels of HSP86 and ERKs. CONCLUSION: MLA pretreatment can attenuate I/R injury in porcine hearts. The protective mechanism might be associated with ERKs-induced upregulation of HSP86 synthesis.

Objective To select the aptamer to an extracellular soluble fragment of recombinant human TGF-? receptor Ⅱ (TGF-? RⅡ) in order to antagonize TGF-? effectively by using systematic evolution of ligants by exponential enrichment (SELEX). Methods Initial random RNA library was transcripted in vitro from ssDNA 5′-TAATACGACTCACTATAGGGAGGACGATGCGG-N60-CAGACGACTCCCCGA-3′; rhTGF-? RⅡ was used as target protein. Totally,selection of 8 times was carried out in SELEX experiment. Membrane binding assay was performed to detect the evolution of enriched RNA library; Electrophoretic mobility shift assay (EMSA) was done to determine the affinity between the selected nucleic acid sequence and TGF-? RⅡ. Results Evolution of the enriched RNA library along the increased affinity to TGF-? RⅡ was observed with the development of selection. Two types of dominant sequences were isolated and named as sequence A and sequence B. In membrane binding assay,both sequences A and B showed obvious affinity to TGF-? RⅡ. However,no retarded bands were seen in EMSA. Conclusion The affinity of sequences A and B to TGF-? RⅡ is beyond satisfaction. However,possible sequences with improved affinity to TGF-? RⅡ can be selected by post-SELEX on the basis of candidate sequences A and B.

Objective The objective of this study was to investigate the relationship between the expression of RAD18 and radiation resistance in glioblastoma multiforme(GBM)and to provide a new therapeutic target for improving the radiation resistance of GBM.Methods Human glioma A172 cells were transfected into blank and RAD18-containing plasmid vector.The cell proliferation of two groups after the same dose radiation was detected by cloning assay.The mRNA expression of RAD18 in primary and recurrent GBM samples after close proximity treatment were detected by qRT-PCR.All data were analyzed statistically.Results The proliferation of GBM cells transfected with RAD18 plasmid was higher than that of cells transfected with blank plasmid after radiation therapy(P<0.001).The expression level of RAD18 mRNA in recurrent GBM was higher than that in the untreated radioactive granules primary GBM(P<0.01).Conclusion The resistance of recurrent GBM to radiotherapy may be associated with the overexpression of RAD18 protein.