Objective: To investigate the mechanism of the effect of Linweidihuang Pills on diabetic neuropathy in rat. Methods: The diabetic rats were induced by alloxan. Serum glucose was tested by glucose oxidase and sciatic nerve sorbitol was determined by GC. Results: After Liuweidihuang Pills,0.5～2g/kg taken orally for 3 months, the level of sciatic nervous sorbitol and serum glucose in rat decreased significantly and the results showed certain dose effect relationship.Conclusion: Liuweidihuang Pills can controll diabetic neuropathy by inhibiting sorbitol biosynthesis.

Objective To evaluate the value of TruviewTM EVO2 optical laryngoscope for emergency endotracheal intubation in the clinical application.Methods Forty-four patients in need for emergency endotracheal intubation were randomly (random number) divided into two groups:the observation group (TruviewTM EVO2 optical laryngoscope for tracheal intubation,n =22) and the control group (ordinary laryngoscope for tracheal intubation,n =22).Parameters recordered included C/L (Cormack-Lehane)grade,the time taken for successful intubation,tracheal intubation times,lowerest SpO2 during the intubation and the incidences of complications after intubation.IDS (intubation difficulty scale) scores were calculated and the total effective rates were compared.Results The data showed that there were no significant differences in the duration of the successful endotracheal intubation attempts between the two groups,respectively (24.04 ±6.56) s and (21.97 ±8.92) s,P ＞0.05.The C/L grade with the observation group was 10∶ 9∶ 3∶0 (Ⅰ ∶ Ⅱ ∶ Ⅲ∶ Ⅳ),which was significantly better than that with the control group (3∶ 7∶ 9∶ 3,P ＜0.01).The tracheal intubation times of the observation group was 17∶ 5∶0 (one time∶ two times∶ three times),which was significantly better than that of the control group (9∶ 8∶ 5,P ＜0.01).The minimum of SpO2 in the observation group (97.31 ± 1.64)％ was significantly higher than that in the control group (92.03 ± 5.39)％,(P ＜ 0.01).The incidence of complications after intubation was lower in the observation group.The IDS score in the observation group (0.68 ± 0.38) was much lower than those in the control group (2.54 ± 1.49),(P ＜ 0.01).In addition,the total effective rate of the observation group (86.36％) was significantly higer than that in the control group (45.45％),(P ＜0.01).Conclusions Using optical laryngoscope for emergency endotracheal intubation could facilitate the glottis exposure and reduce C/L grade effectively.It could lead to lower the incidence of complications and increase the success rate of tracheal intubation.

Objective To investigate the effect of blood hemoperfusion with resin adsorption connected in series to continuous veno-venous hemofiltration ( HP + CVVH) on plasma cytokines such as TNF-α,IL-1β,IL-6 as well as cellular immunity and prognosis of patients with multiple organ dysfunction syndromes (MODS). Methods It was a prospective,randomized clinical trial.A total of 30 patients diagnosed as MODS were randomly (random number) divided into routine treatment + HP + CVVH group (treatment group) and routine treatment + CVVH group (control group).In treatment group,patients received blood hemoperfusion with resin adsorption for 2 hours,and then CVVH for 10 hours every day for 3days.In control group,patients received CVVH for 12 hours every day for 3 days.The plasma samples of patients in treatment group were obtained 0 h,2 h,12 h,24 h,26 h,36 h,48 h,50 h,60 h,5 days,7 days and 10 days after renal replacement therapy.The plasma samples of patients in control group were obtained 0 h,12 h,24 h,36 h,48 h,60 h,5 days,7 days and 10 days after renal replacement therapy.All of these patients were monitored with APACHE Ⅱ score,T-lymphocytes subpopulations,blood lactate acid concentration,heart rate,respiration rate and oxygenation index. Results Plasma levels of TNF-α,IL-1β and IL-6 decreased dramatically after HP (P ＜ 0.01 ) and T-lymphocytes subpopulations CD3+,CD4 +,CD8 + and CD4 +/CD8 + increased after both HP + CVVH and CVVH.The differences in plasma levels of TNF-α,IL-1βand IL-6 of patients between two groups were not noticeably obvious at the intervals of 12 h,36 h,and 50 h after renal replacement therapy. But on the 5 th day after renal replacement therapy,plasma levels of TNF-α,IL-1βand IL-6 of patients in HP + CVVH group were lower than those in control group (P ＜ 0. 05 ).There were 5 fatal patients in HP + CVVH group and 6 patients died off in CVVH group during 28 days after treatment.Conclusions Both HP + CVVH and CVVH could lower the levels of plasma TNF-α,IL-1β and IL-6,and improve cellular immunity and clinical symptoms as well as signs.Compared with CVVH,plasma levels of TNF-α,IL- 1β and IL-6 were lower on the 5th day and increase rate of 28-day survival in HP + CVVH group.

OBJECTIVE To observe the type of nosocomial infections in our comprehensive ICU,the prevalence and the vicissitude characteristic of infection strains,and the change of antibiotic-resistance.METHODS To summarize the 10 year results of the monitoring which were divided into three stages to compare the changes with time.RESULTS Gram-negative bacilli were 987(76.4%),Gram-positive cocci 216(16.7%) strains,and 89 strains were fungi(6.9%).The top six strains were in turn:Pseudomonas aeruginosa,Acinetobacter baumannii,Staphylococcus aureus,Klebsiella pneumoniae,Escherichia coli,and Stenotrophomonas maltophilia.Distribution of infection sites: 92.3% infection was in lungs,5.2% in urinary tract infection,2.5% in other sites included lungs,abdomene,CSF,blood etc.CONCLUSIONS The main nosocomial infective pathogens in our ICU are Gram-negative bacilli(75.0%),Gram-positive bacterial infection shows a slight increasing,whereas fungi infection decreasing.In addition to S.maltophilia,the great majority of Gram-negative bacilli,ESBL-producing K.pneumoniae and E.coli maintain a higher sensitivity to carbapenem antibiotic.All Gram-positive cocci to vancomycin and teicoplanin maintain a good sensitivity.In the fungal infection,Candida albicans infection ratio is decreased,while non-C.albicans increases.

ObjectiveTo investigate the clinical types and features of chronicity of drug-induced liver injury (DILI). MethodsThe patients who were diagnosed with DILI in Beijing You′An Hospital, Capital Medical University from January 2011 to December 2013 were screened, and a retrospective analysis was performed for 84 patients with chronic DILI. The case report form was filled out for each patient, and the data were entered into a database, including demographic features, underlying diseases, types of drugs, cardinal symptoms and signs, and laboratory examinations. ResultsOf all patients, 63 (75.0%) were female. The chronicity of DILI could be divided into six clinical types according to disease progression and recovery of liver function; of all patients, 64 (762%) had a recurrent type, 4 (4.8%) had a delayed recovery type, 4 (4.8%) had a recurrent fluctuation type, 6 (7.1%) had a chronic cholestasis type, 5 (6.0%) had a type of rapid progression to liver cirrhosis, and 1 (1.2%) had a type of drug-induced autoimmune hepatitis. Among all the 84 patients, 56 (66.7%) had underlying diseases; 51 (60.7%) had DILI induced by a single drug, mainly traditional Chinese medicine (47.0%), antipyretics and analgesics (10.6%), and antitubercular agents (9.1%); as for the type of liver injury, 52 (61.9%) had hepatocyte injury, 8 (9.5%) had cholestasis, and 5 (6.0%) had a mixed type. Liver biochemistries showed abnormal results in 19 patients (22.6%). ConclusionThe chronicity of DILI can be divided into six clinical types, of which the most common type is the recurrent type, and the other clinical types include delayed recovery type, recurrent fluctuation type, chronic cholestasis type, rapid progression to liver cirrhosis, and drug-induced autoimmune hepatitis.

Objective To analyze the pathogenesis and clinical characteristics of drug-induced liver injury (DILI) and to explore the corresponding nursing interventions. Methods From January 2011 to December 2013, a total of 84 patients with chronic drug-induced liver injury in Beijing You'an Hospital were recruited by convenience sampling method according to the diagnostic criteria of Guidelines for the Management of Drug-Induced Liver Injury. The demographic characteristics, the possible drugs and clinical characteristics were inputted into Epidata management database and were analyzed using SPSS 16.0. Results In the study, there were 132 kinds of drugs which induced chronic liver injury. Thirty-three of all the recruited patients were using over 2 kinds of medications, among which traditional Chinese medicine accounted for 47.0%, which were mainly used for dermatopathy, rheumatosis and healthcare. The second were non-steroidal anti-inflammatory drugs and antituberculosis drugs. Fifty-six patients had underlying diseases, accounting for 66.7%, of which 16 patients had more than 2 underlying diseases. The main clinical manifestations were fatigue, anorexia and jaundice. 14.3% of the patients showed complications. Conclusions The incidence of drug-induced liver injury was increasing with years. It's important to conduct the health education of drug-using safety, especially to the elderly women and the ones with underlying diseases. The course of chronic liver injury was long and tends to relapse, so it's essential to observe the reaction to drugs and take correspondent measures during the nursing work. Besides, we need to pay much attention to psychological counseling of the patients.

Objective To develop a rapid and sensitive method to quantify the substitution of amino acid (aa) 70 in hepatitis C virus (HCV) genotype 1 b core region.Methods Specific primers and TaqManminor groove binder probes were designed to establish a real time reverse transcription-polymerase chain reaction for aa70 substitution.The specificity,sensitivity and accuracy of the system were tested.Results The probes could clearly distinguish 70W and 70M.The detection limit for each system was 5 copies/ reaction.Further tests using cloning sequencing confirmed the reliability of the detection system.Conclusions A novel system was developed and provides an effective,sensitive,and accurate approach to quantify the wild type and mutant strains of HCV 1b core region as70.