OBJECTIVE:To study the compatible stability of Ceftriaxone Sodium with Compound Sodium Chloride Injection or Sodium Lactate Ringer's Injection and study the compatible stability of the simulated in vivo peak concentration of ceftriaxone sodium with instant high concentration of calcium gluconate ion injection. METHODS: The concentration of Ceftriaxone Sodium in the mixture was determined by HPLC,meanwhile,the changes of the mixture in appearance,pH value,and the insoluble particles at room temperature were observed. RESULTS: At 0～2 hours,the mixture of Ceftriaxone Sodium and Compound Sodium Chloride Injection was clear in appearance;however,at 2 hours,it was white cloudy macroscopically,and its pH valued increased,ceftriaxone sodium content decreased and insoluble particles increased. The ceftriaxone sodium content reduced when mixed with sodium lactate ringer's injection. After mixing of simulated in vivo peak concentration of ceftriaxone sodium with instant high concentration of calcium gluconate ion injection,the appearance of the mixture was stable but the concentration of Ceftriaxone Sodium reduced slightly. CONCLUSION: Ceftriaxone Sodium can't be used in combination with Compound Sodium Chloride Injection or Sodium Lactate Ringer's Injection. Whether it is suitable to infuse calcium gluconate when ceftriaxone sodium (iv gtt) reached peak concentration remains to be confirmed in future study.

0.05). But the level of HbA1c, 2 hour insulin and C peptide were significantly lower than that in CG (P 0.05). Conclusion Wei li acupuncture therapy instrument can improvement the islet ?-cell function in patients with type 2 diabetes mellitus.

Objective To discuss the expression and clinical significance of vascular endothelial growth factor (VEGF)-C and nm23-H1 in colorectal carcinoma.Methods Immunohistochemical staining was employed to determine the expression of VEGF-C and nm23-H1 in the carcinoma tissues of 120 cases with colorectal carcinoma and in the adjacent mucosal tissues of 55 cases as control,and analyzed their correlation with cliniopathological features and prognosis.Results The positive expression of VEGF-C in the carcinoma tissues was 71.7％ (86/120),significantly higher than that in the adjacent mucosal tissues [21.8 ％ (12/55)],and there was significant difference (x2 =35.186,P ＜ 0.01).The positive expression of nm23-H1 in the carcinoma tissues was 57.5％ (69/120),significantly lower than that in the adjacent mucosal tissues [90.9％ (50/55)],and there was significant difference (x2 =18.351,P ＜ 0.01).The expression of VEGF-C was significantly correlated with lymph node metastasis (P ＜ 0.05),and the expression of nm23-H 1was significantly correlated with lymph node metastasis and pathological type (P ＜0.01 or ＜0.05).The expression of VEGF-C and nm23-H1 did not show a significant correlation with gender,age,tumor size,tumor site and depth of invasion (P ＞ 0.05).Spearman correlation analysis showed that the expression of VEGF-C was negatively correlated with the expression of nm23-H 1 in colorectal carcinoma (r =-0.472,P ＜0.01).Conclusions The joint detection of VEGF-C and nm23-H1 expression is very promising in prediction of the prognosis of patients with colorectal carcinoma.However,whether it can be used as a marker in prognosis judgment need further investigation.

Objective To investigate the efficacy and influence factors of hysteroscopic guiding endometrial resection on dysfunctional uterine bleeding.Methods One hundred and eighty women with dysfunctional uterine bleeding were selected as our subjects in Maternal and Child Health Hospital of Qinhuangdao from Jan.2009 to Jan.2011.One hundred and fifty which meet with operation indications underwent hysteroscopic guiding endometrial resection.Operation periods,blood loss,adverse effects rate were recorded.Serum follicle stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2) and progesterone (P) hormone levels were detected at preoperative and postoperative.The efficacy was recorded at 6 and 12 months after the procedure.Results The average operation time and amount of bleeding were (31.2 ± 11.0)min and (32.3 ± 10.5) ml,and no blood transfusion performed during the operation.All cases got the succeed operation.There were no significant difference in terms of serum FSH,LH,E2 and P concentrations before and after treatment(P ＞0.05).At 6 months after treatment,improvement rate was 64.0％ (96/150),and effective rate was 32.0％ (48/150).The total effective rate was 96.0％ (144/150).At 12 months after treatment,the improvement rate was 58.0％ (87/150),effective rate was 36.0％ (54/150).The total effective rate was 94.0％(141/150).There was significant different in terms of total effective rate between 6 months and 12 months after treatment(x2 =113.6,P ＞ 0.05).Postoperative complications occurred in 2 cases,including 1 cases of abdominal pain,and 1 cases of dysmenorrhea.Uterine cavity depth,age and disease duration were the main factors affect the clinical efficacy.(OR(95 ％ CI):-1.14 (-1.17 to-1.07),1.60 (1.31 to 2.08),-1.02(-1.14 to-1.08),P ＜ 0.05).Conclusion Treatment of hysteroscopic guiding endometrial resection on dysfunctional uterine bleeding is proved to be efficacy due to the less adverse reaction.

Objective:To investigate the induction of apoptosis by isoalantolactone in human cervical cancer Hela cells is mediated through ROS generation and Mitochondrial dysfunction. Methods: Cells were treated with isoalantolactone in a dose-dependent manner in the presence or absence of NAC for 24 h as the experimental group,and the normal cells were used as control group. Cell viabilities were determined by the MTT assay;the nuclear morphology of Hela cells were observed under fluorescence microscope using the Hoechst 33258 staining;apoptosiscell cycle and reactive oxygen species ( ROS ) and mitochondrial membrane potential(MMP) were measured by flow cytometry;the protein expression levels of cytochrome C,Bcl-2,Bax and Caspase-3 were detected by Western blot. Results:In the present study,we found that isoalantolactone inhibits growth in a dose-dependent manner in Hela cells. Further studies revealed that Hela cells were treated with 20 and 40 μmol/L isoalantolactone for 24 h,after which we could observe the fragmented nuclei and the increased apoptosis rate. And we also found that isoalantolactone arrested the cell cycle at S phase and increased generation of reactive oxygen species and dissipation of mitochondrial membrane potential (△ψm) in Hela cells. While pretreatment with NAC obviously blocked the apoptotic and inhibition effect of isoalantolactone indicating that induction of apoptosis is ROS-dependent,Western blot study showed that isoalantolactone increased the expression of Bax and cleaved Caspase-3 and decreased the expression of Bcl-2 with concomitant release of cytochrome C from mitochondria into cytosol. Conclusion: Isoalantolactone could inhibit the proliferation and induce the apoptosis of human cervical cancer Hela cells in vitro through mediating ROS generation and Mi-tochondrial dysfunction, the mechanism of which is also accompanied by up-regulation of Bax expression, down-regulation of Bcl-2 expression,activation of Caspase-3 and release of cytochrome C.

Objective To investigate the timing and value of noninvasive ventilation (NIV) as a weaning tool immediately after early extubation in patients with acute respiratory distress syndrome (ARDS).Methods A prospective randomized controlled trial was conducted.The ARDS patients with surgical diseases admitted to Department of Respiratory Intensive Care Unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University were enrolled.The patients were randomly divided into sequential group and control group.All patients underwent endotracheal intubation and were mechanically ventilated.Every 12 hours during the first 3 days,the lung recruitment maneuver was performed during pressure control ventilation (PCV).After lung recruitment,all patients were ventilated with synchronized intermittent mandatory ventilation (SIMV) + pressure support ventilation (PSV) + positive end-expiratory pressure (PEEP) or assistant/control ventilation (A/C).The objects in sequential group who met the following criteria including those with oxygen index (PaO2/FiO2) reaching 200-250 mmHg (1 mmHg=0.133 kPa) under PEEP of 8 cmH2O (1 cmH2O =0.098 kPa),and pressure support of 12 cmH2O,and most acute infiltrating lesions having resolved on chest imaging,received noninvasive ventilation (NIV) immediately after extubation,and patients in control group continued to have invasive mechanical ventilation via intubation or tracheostomy with an endotracheal tube.The baseline data in both groups and the number of re-intubation in the sequential group were recorded.The duration of invasive mechanical ventilation and total duration of mechanical ventilation,ICU length of stay,the incidence of ventilator-associated pneumonia (VAP),and mortality rate were compared between the two groups.Results 53 consecutive adult patients were enrolled,including 26 in sequential group and 27 cases in control group.The period of endotracheal intubation was 7.0 (6.8,9.5) days,and 7.7％ (2/26) patients underwent re-intubation in sequential group.There were significant difference in respiratory and circulatory indicators before extubation spontaneous breathing trial (SBT) ≤10 minutes in sequential group,indicating that the patients were still in the early stage of extubation sequential NIV.There was no significant difference in indices reflecting respiratory function and circulation between the two groups,except that respiratory rate at 1 hour was slightly increased in sequential group as compared with that of control group,indicating that sequential NIV could maintain invasive ventilation function.There was significant difference in duration of invasive mechanical ventilation [days:7.0 (6.8,9.5) vs.21.0 (17.0,25.0),Z=-6.048,P=0.000],duration of total mechanical ventilation (days:18.0 ± 4.1 vs.22.0 ± 7.3,t=-2.805,P=0.008),and length of ICU stay (days:21.0 ± 4.1 vs.28.0 ± 8.1,t=-4.012,P=0.000) between sequential group and control group,but there was no significant differences in the incidence of VAP [15.4％ (4/26) vs.29.6 (8/27),x2=1.535,P=0.215] and mortality rate [7.7％ (2/26) vs.18.5％ (5/27),P=0.420].Conclusion When PaO2/FiO2 reached 200-250 mmHg under the condition of low ventilation,sequential NIV facilitates the early discontinuation of mechanical ventilation in ARDS patients with surgical diseases,with shortening of duration of invasive mechanical ventilation,total mechanical ventilation,and the length of ICU stay.

ObjectiveTo investigate the efficacy of invasive-noninvasive sequential mechanical ventilation (MV) in senile patients with severe community-acquired pneumonia (CAP).Methods A prospective study was conducted. The patients with severe CAP aged≥ 75 years admitted to Department of Respiratory Intensive Care Unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University from November 2012 to July 2014, with refusal to have tracheostomy, were enrolled. All patients meeting the diagnostic criteria of CAP and severe CAP were first admitted into the Department of Emergency, and they were found to need MV without absolute contraindication for noninvasive ventilation (NIV) in RICU. The patients were mechanically ventilated via endotracheal intubation (ETI), and they were randomly divided into invasive-noninvasive sequential MV group (sequential MV group) and conventional MV group. NIV was initiated immediately when patients matched the conditions for early extubation in the sequential MV group. Oxygen therapy (5 L/min) via a Venturi mask was provided when the indications of conventional extubation were met. The baseline data and clinical characteristics were recorded, the risk factors of death were analyzed by logistic regression analysis, and 60-day survival rate was analyzed by Kaplan-Meier curve. Results Ninety-one senile patients with severe CAP were enrolled, among them 28 patients died within 60 days, with a mortality rate of 30.77%. No significant difference in 60-day mortality was found between sequential MV group (n = 44) and conventional MV group [n = 47, 25.0% (11/44) vs. 36.2% (17/47),χ2 = 1.331,P = 0.249]. In the sequential MV group, the incidence of ventilator-associated pneumonia (VAP) was significantly decreased [27.3%(12/44) vs. 55.3% (26/47),χ2 = 7.350,P = 0.007], and the rate of ETI≥2 times was increased [59.1% (26/44) vs. 29.8% (14/47),χ2 = 5.095,P = 0.024] as compared with conventional MV group. Compared with survival group, the patients in non-survival group showed a higher incidence of cerebrovascular disease (60.7% vs. 25.4%,P = 0.002), higher acute physiology and chronic health evaluationⅡ (APACHEⅡ) score (26.46±2.59 vs. 24.41±2.47,P = 0.001), British Thoracic Society confusion, uremia, respiratory rate, blood pressure,≥75 years (CURB-75 score, 4.00±0.47 vs. 3.68±0.53,P = 0.013), a longer total duration of MV (days: 21.18±10.02 vs. 14.56±7.62,P = 0.002), and a higher ratio of ETI≥ 2 times (53.6% vs. 33.3%,P< 0.001). It was revealed by multivariate logistic regression analysis that ETI≥ 2 times and comorbidity of cerebrovascular infarction were independent predictors of a worse outcome in the senile patients [odds ratio (OR) = 9.677, 95% confidence interval (95%CI) = 3.075 - 30.457,P< 0.001;OR = 5.386, 95%CI = 1.781 - 6.284,P = 0.003]. It was showed by Kaplan-Meir survival analysis that ETI times and concurrent cerebrovascular infarction imparted significant effects on the 60-day survival rate (χ2 = 40.805,P= 0.000;χ2 = 4.425, P = 0.035).ConclusionInvasive-noninvasive sequential MV may not improve the outcome of senile patients with severe CAP, and ETI≥ 2 times and concurrent cerebrovascular disorders drastically lowered the survival rate.

Objective To evaluate the risk factors for healthcare-associated infection(HAI)in senile dementia pa-tients,so as to adopt effective nursing measures to reduce the incidence of HAI.Methods Clinical data of 82 senile dementia patients aged≥60 years and hospitalized between January 2011 and June 2013 were analyzed retrospective-ly.Results Of 82 patients,28 (34.15%)developed HAI.The main infection site was lower respiratory tract(n=15,53.57%),followed by urinary tract(n=6,21 .43%).Univariate analysis revealed that risk factors for HAI in senile dementia patients were bedridden,long length of hospital stay ,dysphagia,indwelling urinary catheter,irra-tional use of antimicrobial agents,combined with tumor,and hypoproteinemia (all P <0.05 ).The main isolated bacteria were gram-negative bacilli(n=40,62.50%),the top three pathogens were Klebsiella pneumoniae (n=12, 18.75%),Escherichia coli (n =10,15.63%),and Pseudomonas aeruginosa (n =8,12.50%).Conclusion Reali-zing the risk factors and common pathogens of HAI in senile dementia patients is helpful for taking effective meas-ures to prevent and control the incidence of HAI .

OBJECTIVE: To study the role of nuclear factor-kappa B (NF-kappaB) and cycloxygenase-2 (COX-2) in the onset of phlegm obstruction due to lung-deficiency in rats and the therapeutic mechanism of Huatan Recipe. METHODS: Twenty-four SD rats were randomly divided into normal group, model group and treatment group, with 8 rats in each group. The rats in the model group and treatment group were exposed to sulfur dioxide and cold wind to establish the rat model of phlegm obstruction due to lung-deficiency, and the rats in the treatment group were also treated with Huatan Recipe, a compound traditional Chinese medicine. The expression of NF-kappaB in the bronchial epithelial cells of the rats was tested with the method of immunohistochemistry, and the COX-2 mRNA in the lung tissues of the rats was measured by using reverse transcription-polymerase chain reaction. RESULTS: The expressions of NF-kappaB and COX-2 mRNA in rats of the model group were higher than those of the normal group (P<0.01), and the expressions of NF-kappaB and COX-2 mRNA in rats of the treatment group were obviously lower than those of the model group (P<0.01). CONCLUSION: The NF-kappaB and COX-2 play an important role in the onset of phlegm obstruction in rats. Huatan Recipe may prevent the development of phlegm obstruction by down-regulating the expressions of NF-kappaB and COX-2 mRNA.

Objective To observe the effects of permanent magnetic fields with different magnetic inductions on oxidative damage to human brain microvascular endothelial cells (HBMECs) under normal and hypoxic conditions. Methods HBMECs were cultured in vitro under normal and hypoxic conditions,then divided into a control group and groups receiving magnetic induction at 8.1,16.5,20.3,26.0,27.3,62.5,110.7 and 215.6 mT.Changes in superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in each group were measured 72 h after exposure to the magnetic fields. Results Under normal conditions the SOD activities of the magnetic groups were not significantly different from that of the control group. Only the MDA content of the 215.6 mT group was statistically different (slightly higher) than that of the control group (P ＜ 0.05 ).Under hypoxic conditions,there was again no statistically significant difference in SOD activity,but the MDA content of the 110.7 mT group was significantly lower. Conclusions Under normal conditions,a 215.6 mT permanent magnetic field has an effect on MDA in HBMECs; under hypoxic conditions a 110.7 mT permanent magnetic field has such an effect.