Objective To explore the clinical application of fiberoptic bronchoscopy with bronchoalveolar lavage(BAL) in patients with mechanical ventilation.Methods Sixty patients with mechanical ventilation were randomly divided into control group ( n =30) and treatment group ( n =30).All patients accepted anti-infection,nutritional support treatments.The patients in the control group accepted routine treatment;others in the treatment group were treated with BAL.The therapeutic effects in the two groups were evaluated and compared.Results The treatment effects in treatment group was better than that in control group( P ＜0.05).The improvement of blood gas analysis in treatment group was better than in control group (P ＜ 0.05 ),the time of mechanical ventilation,length of stay in treatment group were shorter than those in the control group ( P ＜ 0.05 ).The number of success to remove ventilator,organs failure and hospital mortality in treatment group were less than those in the control group ( P ＜ 0.05 ).Conclusion Fiberoptic bronchoscopy with BAL treatment could be safe and effective for patients with mechanical ventilation.It deserves to be popularized.

Objective To investigate the effect of calcium channel antagonist verapamil upon coronary vessel disease of allograft heart transplant rat model.Methods 160 SD rats weighing 220 to 300 g were randomly allocated to control group (group 1, n=40) and experiment groups (group 2, n=40; group 3, n=40, group 4, n=40). The hearts of all donor rats were implanted into the recipient rats. From the day after operation, the rats in each group were fed routinely and injected intraperitoneally (ip) with Cyclosporin (5 mg?kg~ -1?d~ -1 for 10 days). In experiment groups, the rats were individually injected (ip) with verapamil by 0.1 mg/kg,0.5 mg/kg,1.0 mg/kg twice every day for 3 months, but the rats in control group were not subjected to injection. At 60th and 90th day after grafting, 10 of each group were selected randomly and transplanted hearts were cut. The specimens were stained with HE and histochemistry.Result The degree of intimal hyperplasia in the control group was more severe than in the experiment groups.Conclusion Calcium channel antagonist verapamil can effectively inhibit the intimal hyperplasia of coronary arteries in heart transplant model.

ObjectiveTo observe the influence of the recombinant human growth hormone (rhGH) on nutritional status and immune function in patients with acute respiratory distress syndrome(ARDS).Methods60 ARDS patients with mechanical ventilation hospitalized in the ICU ward were randomly divided into the treatment group and the control group,each group had 30 cases.The patients of the two groups were given the same treatment program of nutritional support,and the patients of the treatment group were administered with rhGH 8u/d,subcutaneous injection,treatment course was 7d.1d before treatment,4d,7d after treatment,the nutrition indicators and changes in immune parameters of the two groups were detected.ResultsThe nutritional status before treatment and the cellular immune parameters of the two groups were lower than normal.4d after treatment,the transferrin requirements(TFN),prealbumin(PA),CD3,CD4,CD8 and CD4/CD8 ratio of the treatment group increased significantly( all P ＜0.05 ) ;7d after treatment,TFN,PA,CD3,CD4,CD8,CD4/CD8 ratio of the treatment group increased significantly compared with the control group ( P ＜ 0.01 ).ConclusionLow-dose hormone therapy combined with the nutritional support could improve the nutritional status,the immune function of ARDS patients with mechanical ventilation and enhance the success rate of patients in emergency.

Objective To evaluate the clinical effect in prevention of intravenous catheter-related infection(CRI) using antiseptic impregnated central venous catheter.Methods Intravenous catheter-related infection was retrospectively analyzed between 440 cases performed with general centrol venous catheter and 420 cases performed with antiseptic impregnated central venous catheter in ICU.Results There were 34 cases of CRI in 860 cases,28 cases were inserted general central venous catheter and 6 cases inserted antiseptic impregnated central venous catheter,the group of antiseptic impregnated was lower singificantly than the group of general in infection rate(P=0.0002).Conclusion Using antiseptic impregnated central venous catheter can reduce CRI,which has clinical effect in prevention of CRI.

Objective To evaluate the effect of evidence- based nursing for patients receiving percutaneous coronary intervention and stent implantation. Methods A total of 136 patients with coronary heart disease were randomly divided into the intervention group (n = 68) and the control group (n = 68). Traditional nursing measures were employed for the patients of the control group , while evidence-based nursing intervention was adopted for the patients of the intervention group. The patient’s comfortableness, satisfaction and the occurrence of complications were determined at 24, 48 and 72 hours after the operation, and the results were compared between the two groups. Results At 24, 48 and 72 h after percutaneous coronary intervention, the each dimension score of GCQ and the total score of the intervention group were significantly higher than those of the control group (P<0.05). The occurrence of back pain, urinary retention and hypotension in the intervention group was significantly lower than those of the control group (P < 0.05). Patient’s satisfaction extent of the intervention group was significantly better than that of the control group (P < 0.05). Conclusion Evidence-based nursing intervention can effectively enhance the nursing skill and orientation, and reduce the occurrence of back pain, urinary retention and hypotension, thus improve patient’s comfortableness and satisfaction. Therefore, evidence - based nursing intervention should be recommended in clinical practice.

Objective To study influence of tongxinluo on blood endothelial microparticles(EM Ps) and matrix metalloprotei‐nase‐9(MMP‐9) in patients with acute myocardial infarction after percutaneous coronary intervention(PCI) .Methods One hundred and twenty‐eight hospitalized patients with acute myocardial infarction after per‐cutaneous coronary intervention were recruited from January 2012 to December 2014 ,All patients were randomly divided into tongxinluo group (n=65) and control group (con‐ventional treatment ,n=63) .Tongxinluo group was on the basis of conventional treatment group with tongxinluo capsules 2 plus ,3 times a day .We detected the EMPs and MMP‐9 of two groups preoperatively and on the 7th postoperatively day .Results Com‐pared with the conventional treatment group ,blood EMPs and MMP‐9 in tongxinluo group were lower after 7 days treatment ,the difference was statistically significant (P<0 .05) .There was a positive correlation between the EMPs and MMP‐9(P<0 .05) .Con‐clusion For patients with acute myocardial infarction after percu‐taneous coronary intervention ,tongxinluo could further inhibit in‐flammatory reaction ,make the plaque stability and improve the function of endothelial cells on the basis of conventional treatment groups .

Objective To investigate the effects of aggressive dosing of atorvastatin on the expression of SOCS1 in CD4 + Tlymphocytes from patients with unstable angina pectoris during peri-operative period of PCI.Methods A cohort of 50 patients with unstable angina pectoris were randomized (random number) to give pretreatment with either an aggressive dose (80 mg/d,n =25) or a routine dose (20 mg/d,n =25)of atorvastatin.Circulating CD4 +T cells were subsequently obtained prior to PCI,and also 18 h to 24 hours after PCI,using a magnetic cell sorting system (MACS).Fluorescence-based quantitative real-time polymerase chain reaction (qRT-PCR) was used to measure expressions of SOCSI mRNA in the isolated CD4 + Tlymphocytes,and western blot analysis was used to detect levels of SOCS1 protein.Serum levels of IFN-γwere quantified using enzyme-linked immunosorbent assays (ELISAs).Results Compared with routine dose group,the expressions of SOCS1 mRNA and protein levels were dramatically increased and those were higher in aggressive dose group following PCI (P ＜ 0.05).In contrast,serum levels of IFN-γsignificantly increased following PCI in both groups,but it was higher in routine dose group than in aggressive dose group (P ＜ 0.05).Conclusions Treatment with aggressive dosing of atorvastatin reduced the post-PCI myocardial inflammatory response in patients with unstable angina pectoris,possibly modulating by up-regulating SOCS1 expression in CD4 + Tlymphocytes.

Objective:To explore the relationships between the endothelial microparticles (EMPs)in peripheral blood and CD4+ CD25 + Foxp3+ regulatory T cells and their cytokine levels in the patients with acute coronary syndrome (ACS),and to clarify the mechanism of EMPs in the pathogenesis of ACS by affecting the Treg cell differentiation and function.Methods:Twenty-three patients with stable angina (SAP)were allocated to SAP group,and 52 patients with ACS were allocated to ACS group.Twenty individuals with normal conventional coronary angiography results were recruited as control group.The levels of EMPs and the percents of CD4+ CD25 +Foxp3+ regulatory T cells in peripheral blood of the patients in various groups were measured by flow cytometry. The expressions of Foxp3 mRNA and the plasma levels of TGF-β1 were detected with Real-Time PCR and ELISA, respectively.Correlation analysis was performed between EMPs and regulatory T cells,Foxp3 mRNA expression level and TGF-β1 level.Results:Compared with control group and SAP group,the level of EMPs in peripheral blood of the patients in ACS group was increased significantly,but the percentage of regulatory T cells,the Foxp3 mRNA expression level and the plasma TGF-β1 level were decreased markedly (P <0.01).The correlation analysis showed that there were significantly negative correlation between EMPs and regulatory T cells,Foxp3 mRNA expression level and TGF-β1 level (r = - 0.452,P = 0.001;r = - 0.466,P = 0.001;r = - 0.555,P = 0.000 ). Conclusion:EMPs may involve in the process of occurrence and development of ACS and plaque instability by regulating the differentiation and function of CD4+ CD25 + Foxp3 + regulatory T cells.

BACKGROUND:Fisher-Lewis rat kidney transplant models are the international common chronic renal alograft rejection models, but their application is greatly limited because of difficulty in model preparation and high costs. OBJECTIVE:To explore a new method of establishing SD-Wistar rat models of chronic renal alograft rejection. METHODS: Fifty-six pairs of SD-Wistar rats were subjected to left kidney orthotopic transplantation. The right kidneys of the recipients were intact and used as internal controls. 23 rat recipients were randomly divided into model group (n=15) and control group (n=8). The rats in the model group were injected with cyclosporine microemulsion for 10 days (2 mg/kg/day,i.p.) after kidney transplantation. The rats in the control group were not treated with immunosuppressive therapy. RESULTS AND CONCLUSION:The irreversible acute rejection occurred in al the transplanted kidneys of rats in the control group within 4 weeks, leading to the necrosis of transplanted kidney. Moderate inflammatory cel infiltration appeared in the transplanted kidneys of rats in the model group at 4, 8 and 12 weeks after transplantation. Typical histopathological changes of chronic rejection were observed within 12 weeks after transplantation. The Banff total scores were increased with time after transplantation. Al these histopathological changes were not observed in the intact right kidneys of rat recipients in both groups. The valey value of 

This study examined the protective effect of ischemic postconditioning (IPoC) and minocycline postconditioning (MT) on myocardial ischemia-reperfusion (I/R) injury in atherosclerosis (AS) animals and the possible mechanism. Forty male healthy rabbits were injected with bovine serum albumin following feeding on a high fat diet for 6 weeks to establish AS model. AS rabbits were randomly divided into 3 groups: (1) I/R group, the rabbits were subjected to myocardial ischemia for 35 min and then reperfusion for 12 h; (2) IPoC group, the myocardial ischemia lasted for 35 min, and then reperfusion for 20 s and ischemia for 20 s [a total of 3 cycles (R20s/I20s×3)], and then reperfusion was sustained for 12 h; (3) MT group, minocycline was intravenously injected 10 min before reperfusion. The blood lipids, malondialdehyde (MDA), superoxide dismutase (SOD), soluble cell adhesion molecule (sICAM), myeloperoxidase (MPO), and cardiac troponin T (cTnT) were biochemically determined. The myocardial infarction size (IS) and apoptosis index (AI) were measured by pathological examination. The expression of bcl-2 and caspase-3 was detected in the myocardial tissue by using reverse transcription-polymerase chain reaction (RT-PCR). The results showed that the AS models were successfully established. The myocardial IS, the plasma levels of MDA, sICAM, MPO and cTnT, and the enzymatic activity of MPO were significantly decreased, and the plasma SOD activity was significantly increased in IPoC group and MT group as compared with I/R group (P<0.05 for all). The myocardial AI and the caspase-3 mRNA expression were lower and the bcl-2 mRNA expression was higher in IPoC and MT groups than those in I/R group (all P<0.05). It is concluded that the IPoC and MT can effectively reduce the I/R injury in the AS rabbits, and the mechanisms involved anti-oxidation, anti-inflammation, up-regulation of bcl-2 expression and down-regulation of caspase-3 expression. Minocycline can be used as an effective pharmacologic postconditioning drug to protect myocardia from I/R injury.