ObjectiveTo investigate the effect of different degrees of pressure of sustained inflation (SI) in patients with acute respiratory distress syndrome (ARDS) after lung recruitment as the result of different negative pressure for sputum aspiration.Methods A prospective single-blind randomized controlled trial was conducted. The factorial analysis of variance was adopted. 150 patients with ARDS admitted to the emergency intensive care unit (ICU) of Chongqing Three Gorges Central Hospital from January 2012 to December 2014 were enrolled, and they were randomly divided into S1, S2, S3 group, with 50 patients in each group, suction pressure varying from 150, 175, to 200 mmHg (1 mmHg = 0.133 kPa) was respectively used in each group. Then the patients of each group were randomly subdivided into five subgroups of P0, P1, P2, P3, P4, with 10 patients in each group, and 0, 30, 35, 40, and 45 cmH2O (1 cmH2O = 0.098 kPa) were used for control pulmonary inflation pressure, respectively. The respiratory mechanics and the hemodynamic parameters were recorded, and they were compared before and after the sputum aspiration as well as lung recruitment with sustained inflation.Results The lung recruitment volume (mL: 87.56±28.47 vs. 109.38±34.63, t = 3.573,P = 0.001) and lung static compliance [Cst ( mL/cmH2O): 27.69±13.25 vs. 35.87±17.47,t = 2.814,P = 0.004] after sputum aspiration in the 150 patients were significantly lower than those before the sputum aspiration, and peak airway pressure [PIP (cmH2O): 24.16±8.28 vs. 18.63±6.67,t = 2.957,P = 0.005], airway plateau pressure [Pplat (cmH2O): 21.28±9.14 vs. 17.47±7.26,t = 2.089,P = 0.032], and mean airway pressure [Pm (cmH2O): 13.26±4.65 vs. 10.41±3.54,t = 3.271,P = 0.001] were significantly higher than those before the treatment. There were no significant differences in the lung recruitment volume, Cst, PIP, Pplat and Pm between groups with different negative pressure for sputum aspiration (F value was 0.809, 0.986, 1.121, 0.910, 1.043, andP value was 0.452, 0.381, 0.335, 0.410, 0.361), but statistical significance was found among different groups of different lung recruitment pressures (F value was 3.581, 5.028, 3.064, 3.036, 4.050, andP value was 0.013, 0.002, 0.026, 0.027, 0.007). There was no interaction between the two factors. After pairwise comparison, under the same negative pressure for sputum aspiration, lung recruitment volume and Cst in different lung recruitment pressures subgroups (P1, P2, P3, P4) were significantly higher than those of P0 subgroup, and PIP, Pplat, and Pm were significantly lower than those of P0 subgroup. There was no significant difference among P1, P2, P3 and P4 groups. There were no significant differences in mean arterial pressure (MAP) and pulmonary arterial pressure (PAP) among different groups with negative pressures for sputum aspiration and different lung recruitment pressures (negative pressure for sputum aspiration:F = 0.586,P = 0.561,F= 1.373,P = 0.264; lung recruitment pressure:F = 1.313,P = 0.280,F= 1.621,P = 0.186), there was no interaction between the two factors (F = 0.936,P = 0.497,F = 1.391,P = 0.227). The difference of heart rate (HR) in different negative pressure for sputum aspiration groups was not significant (F = 1.144,P = 0.328), and there were significant differences in different lung recruitment pressure groups (F = 3.297,P = 0.019), there was no interaction between the two factors (F = 1.277, P = 0.280). After pairwise comparison, under the same negative pressure for sputum aspiration, HR in P3 and P4 subgroups was significantly higher than that in P0, P1, and P2 subgroups (allP< 0.05).Conclusion 30 cmH2O and 35 cmH2O were the suitable pressure for SI in ARDS patients, and they were not affected by different negative pressure for sputum aspiration.

Articles, reviews and proceeding papers published from 2012 to 2015 in medical, chemical and physical journals with the highest IF were retrieved from 2014 JCR and analyzed using the BICOMB software to generate the co-occurrence matrix of authors and plot the map of co-authorship network in medical, chemical and physical fields using the UCINET software.The correlation between the parameters for assessing the importance of co-au-thorship network nodes ( degree centrality, betweenness centrality, closeness centrality, eigenvector centrality) and biblimetric parameters of authors ( number of published papers, frequency of cited papers) was analyzed using the SPSS, which showed that degree centrality, betweenness centrality, and eigenvector centrality were positively corre-lated with the number of published papers and the frequency of cited papers whereas betweenness centrality was negatively correlated the number of published papers and the frequency of cited papers.Betweenness centrality was more significantly correlated with the number of published papers whereas degree centrality was more significantly correlated with the frequency of cited papers.

Objective: To explore the relationship between plasma level of N terminal pro brain natriuretic peptide (NT-proBNP) and severity of coronary artery lesion in patients with coronary heart disease (CHD). Methods: A total of 206 patients suspected CHD, who admitted from Jan 2010 to Jun 2012 in our department and underwent coronary angiography (CAG), were divided into single vessel coronary disease group (n=54), double-vessel coronary disease group (n=52), multi-vessel coronary disease group (n=67) and normal group (n=33), according to CAG examination; and divided into acute myocardial infarction (AMI) group (n=45), unstable angina pectoris (UAP) group (n=91), stable angina pectoris (SAP) group (n=43) and normal group (n=27) according to clinic symptom. All patients received measurement for NT-proBNP, creatine kinase-isoenzyme (CK-MB) and cardiac troponin I (cTnI). Stenotic severity of coronary artery lesion was evaluated using Gensini score method. Data of all groups were analyzed statistically. Results: Compared with SAP group and normal group, there was significant increase in plasma level of NT-proBNP [(2.28±0.22) vs. (2.18±0.69) vs. (2.94±0.24) vs. (2.74±0.15), P<0.01 or P<0.05] in AMI group and UAP group. Compared with normal group, there was significant increase in plasma level of NT-proBNP [ (2.07±0.43) vs. (2.44±0.38) vs. (2.69±0.34) vs. (2.98±0.28), P<0.05] in single, double and multi-vessel coronary disease groups. Plasma level of NT-proBNP was positively correlated with Gensini score (r=0.51, 0.67, 0.73 respectively in single, double and multi-vessel coronary disease group, P<0.05 all). Conclusion: NT-proBNP concentration can be regard as an index predicting severity of coronary artery lesion.

Objective To explore the protective effects of puerarin on the colon tissue of the mice with chronic alcoholism through observing the changes of quantity and morphology of interstitial cells of Cajal (ICC)and the expression of c-kit protein in colon tissue of chronic alcoholism mice.Methods 24 healthy BALB/C mice were randomly divided into saline control group (SC group ), chronic alcoholic intoxication group (CAI group ) and puerarin pretreatment group(PUE group).The models of chronic alcoholism mice were established in CAI group and PUE group. The intestinal transmission rate was tested by measuring the Indian ink advancing length;immunofluorescence and transmission electron microscope (TEM)were applied to detect the distribution, quantity and ultrastructure of ICC;Western blotting method was used to analyze the C-kit protein expression.Results The intestinal transmission rate in PUE group was significant higher than that in CAI group(P<0.05),but was still lower than that in SC group (P<0.05);compared with CAI group,the number of ICC in PUE group was increased (P<0.05),but there was no significant difference between SC group and PUE group(P>0.05).Compared with SC group,the ultrastructure of ICC in CAI group had obvious changes,the organelles were decreased,and the mitochondrion was swelling.But those changes were reversed in PUE group and the number of mitochondria was increased.The expression of C-kit protein in PUE tissue was higher than that in CAI group (P<0.05),but there was no significant difference compared with SC group.Conclusion Puerarin has a repair or reverse effect on the changes of the number,ultrastructure of ICC and C-kit protein expression caused by alcohol.

Humans ; Laryngoscopy ; adverse effects ; Larynx ; injuries

Objective To establish a RP-HPLC method for simultaneous quantitative determination of 4 anthraquinones in Shugan Quzhi capsules. Methods A RP-HPLC method was used with a Diamonsil C18 column (5 ?m,4.6 mm?150 mm). The mobile phase was composed of methanol and 0.1% H3PO4 water solution (77∶23,v/v). The wavelength of UV detector was 254 nm and column temperature was 30 ℃. Flow rate was 1.0 mL/min and 20 ?L was injected every time. Results The linear ranges of rhein,emodin,chrysophanol and physcion were 0.083 2～2.08,0.100 8～2.52,0.291 2～7.28 and 0.088～2.20 ?g/mL,respectively. Their average recoveries were 97.3%,96.9%,96.5% and 95.9%,respectively. Conclusion This method was sensitive,repeatable and suitable to determine the contents of 4 anthraquinones in Shugan Quzhi capsules.

Objective To analyze the prognostic factors for patients with hepatic encephalopathy (HE) in acute-on-chronic liver failure(ACLF).Methods A retrospective analysis was performed on 159 ACLF patients with HE.The hepatic encephalopathy was determined to baseline,the patients were divided into survivors(n =13) and nonsurvivors(n =146),The 32 factors affecting the prognosis were analyzed by Cox proportional hazard model with SPSS.Results One-month,three-month,and six-month survival rates were 20.13％,10.06％ and 8.18％,respectively.Cox regression analysis of prognostic factors showed that it could the stage of hepatic encephalopathy and HRS significantly improve the survival rate of the patients with HE in acute-on-chronic liver failure.The stage of hepatic encephalopathy and HRS could significantly decrease the survival rate of the patients(x2 =18.344,11.368,all P ＜ 0.05),elevated the levels of hepatic encephalopathy (relative risk (RR) =1.591) and HRS (RR =1.809) indicate worse prognosis with hepatic encephalopathy in acute-on-chronic failure.Conclusion The stage of hepatic encephalopathy and HRS were independent risk factor sof prognosis in acute-on-chronic liver failure.

OBJECTIVE To raise the sci-tech components of the infection control work guided by evidence-based medicine.METHODS To apply the basic principle of evidence-based medicine in the actual work and carry on the argument and analyses. RESULTS The implement of these measures under the guidance of evidence-based medicine could raise the level of the infection control work effectively,which included consult rule of the Hospital Infection Committee,collection of information in network,evaluation and analysis of the examination result of clinical microbiological laboratory,integreted and individualized dynamic monitoring method and diversity and whole process intervention measure.CONCLUSIONS The infection control work guided by evidence-based medicine can reduce the occurrence of the hospital infection effectively.

OBJECTIVE To investigate the methods of promoting nosocomial infection administration in laminar airflow(LAF) operation department,based on the theory of air microbe and object surface microbe. METHODS To begin with the construction standard of LAF operation department,to discuss difficult,complicating,professional and legal characteristics of nosocomial infection administration of LAF operating room. RESULTS It was a solid base of promoting nosocomial infection administrition to specify strictly the standard for the LAF operation department built;it was a vital link of promoting nosocomial infection administrition to take part in inspecting the engineering quality of LAF operation department;it is an effective means of LAF nosocomial infection administrition to carry out the supervision and control to the LAF operation department daily;it was the essense of promoting nosocomial infection administrition to make efforts to innovate the modern administration pattern in LAF operation department. CONCLUSIONS The management of hospital infection in the LAF operation department must emphasize the comprehensive measure of the all-directional germ control,make standard of decontamination of air conditioning guarantee system and carry out the whole process supervision.

Objective To investigate the association between the target organ damage and morning blood pres- sure surge(MBPS) in the elderly hypertensives.Methods Three hundred thirty-two patients submitted to 24 h ambulatory blood pressure monitoring were categorized as with MBPS (n=173),and non-MBPS(n=149).Total cholesterol,body mass index(BMI),left ventricular mass index (LVMI),carotid endothelial medium thickness (CCA-IMT and ICA-IMT) and corrected QT dispersion(QTcd) were determined.Results 24 h,day and night mean systolic blood pressure in MBPS group were significantly higher than that in the non-MBPS group(P