Objective To investigate the application and nursing care of bronchoalveolar lavage (BAL)by fiberoptic bronchoscopy in patients with mechanical ventilation. Methods 64 patients with mechanical ventilation in RICU were randomly divided into the control group and the observation group with 32 patients in each group. The patients in both groups were accepted anti-infection, atomization inhalation and other supportive treatments. The patients in the observation group were treated with BAL, and the patients in the control group accepted routine treatment. The therapeutic effects in the two groups were evaluated and compared. Results There was significant difference in the recovery rate and effective rate, the blood gas analysis compared with the control group was significantly improved, the time of pulmonary infection control window, mechanical ventilation, length of stay were shorter than the control group. The case number to remove ventilator successfully, organs failure and hospital mortality were less than the control group. Conclusions Fiberoptic bronchoscopy with BAL treatment could be safety and efficacy for patients with mechanical ventilation. Nursing intervention plays an important role and a good therapeutic effect for improving achievement ratio of BAL.

Animals ; Animals, Newborn ; Brain ; blood supply ; drug effects ; metabolism ; Female ; Hypoxia-Ischemia, Brain ; physiopathology ; Immunohistochemistry ; Lipopolysaccharides ; toxicity ; Male ; Models, Animal ; Random Allocation ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; analysis

Objective To explore the risk factors of neonatal necrotizing enterocolitis(NEC)and assess the effect of prophylactic use of probiotics(Bifico)in prevention of NEC and observe changes of weight.Methods Five hundred and twenty-four cases of prematures who were inpatients were divided into 2 groups randomly(prevention group,n=276,no-prevention group,n=248)and the morbidity of NEC and the increase of eight during hospitalization were observed.A case-control study and conditional Logistic regression model multifactorial analysis were made to 20 cases NEC neonates and 80 cases non-NEC neonates.Results The prevention group(276 cases)had 5 cases of NEC and the average weight increase was(8.114?8.137)g/d,the no-prevention group 248 cases had 17 cases of NEC,and the average weight increase was(6.595?5.337)g/d.The occure rate of NEC in prevention group was significantly lower than that of no-prevention group(?2=5.57 P

Objective Acute type A aortic dissection associated pregnancy severely threatens the lives of both the mother and her ferus.We retrospectively reviewed our clinical experience with this life-threatening condition in six cases.Methods Between January 2007 and February 2012,6 women with acute type A aotic dissection associated pregnancy were treated by our group,with an average of 3 1 years (range 24 -37 weeks)and a mean gestation weeks of 24.5 (range,12 -38 weeks ).The etiology was Marfan syndrome in 4 cases and gestational hypertension in 2.The pathology was the modified Stanford type A3S in I case,A2C in 2 and A3C in 3.- Five patients were treated surgically and 1 medically.Surgical operations were performed under hypothermic cardiopulmonary bypass or deep hypothermic circulatory arrest,including Bentall procedure in 1case,Bentall + Sun's procedure in 2,ascending aortic replacement + Sun's procedure in 2.Results The woman treated medically and her fetus died from aortic rupture 9 days after admission.The cardiopulmonary bypass and cross clamp time and circulatory arrest time averaged 167 rninites(range,75 -210 minites) and 98 minites(range,83 - 145 minites) and 23.5minites(range,19 -27 minutes),respectively.Five patients treaed surgically survived the operation.Three fetuses survived rand two fetuses died.After a mean follow-up of 2.2 years (range,1 - 3.5 years ),5 patients were doing well.CT angiogram detected nonmal aortic and valvular structures,with no signs of distal dilation.Three babies were normal in development and neurocognitive functios.Conclusion Palients with aortic dissection associated with pregnancy should be operated on ugently and medical treatment carries high risks of aortic rupture and maternal and fetal death.Methods of surgical repair,peffusion techniques and delivery should be chosen based on the underlying aortic pathology and gestational age,so as to maximize the safety of the mother and her baby.

The quality control of new drug cilnical trial is the effective guaranty for the pharmaceutical safety and effective after available on market. Enhancing the inspection and quality control of new drug clinical trials provide the crucial importance to achieve a persistent profitable standard. This paper mainly discussed the problems of current clinical trials based on annual check of drug clinical trial institution.
Clinical Trials as Topic ; Drug Evaluation ; Health Facilities ; Humans ; Quality Assurance, Health Care ; Quality Control

Objective To analyze the clinical outcomes of patients treated with in vitro fertilization and embryo transfer (IVF-ET) and influence factors of pregnancy rate. Methods We retrospectively analyzed the clinical data of 12 491 cycles, including 6832 fresh IVF/intracytoplast single sperm injection (ICSI) cycles and 5659 frozen embryo transfer (FET) cycles from 2005 to 2007. Results The clinical pregnancy rate per cycle was 32. 99% (2254/6832)in fresh embryo transfer program, and the live birth rate was 25.75% (1394/5413); the early pregnant loss rate was 9. 36% (211/2254), and the prenatal defect rate was 1.45% (25/1722). Through analysis of these patients' basic data, we found that the patients' age, causes for infertility, egg retrieval and cycle number affected the pregnancy rate. Using logistic regression method, we found that patients′ age was the most important factor affecting pregnancy outcome. In FET cycles, the clinical pregnancy rate was 38.08% (2155/5659), significantly higher than fresh embryo transfer cycles. Conclusions IVF-ET treatment is a safe and effective method for infertility couples. However, the female age and poor ovarian response are the main factors affecting pregnancy rate. Thawed embryo transfer can increase the accumulated pregnancy rate effectively.

Objective To compare clinical outcome of intracytoplasmic sperm injection(ICSI)cycle by using fresh and cryopreserved-thawed testicular and epididymal spermatozoa in azoospermic patients.Methods Between September 2006 and May 2007,208 azoospermic patients underwent in vitro fertilization(IVF)were treated in Center of Reproductive Medicine,Peking University Third Hospital.Those couples were divided into two groups based on their wishes,including 171 cases in fresh group and 37 cases in cryopreserved-thawed group.The cryopreserved testicular or epididymal spermatozoa were thawed and recovered before ICSI procedure iu thawed group.The outcomes of ICSI in each group were compared.including clinical outcomes(two pronuclear fertilization,high quality embryo,clinical pregnancy and embryo implantation)and pregnancy outcomes(spontaneous miscarriage,gestational weeks and neonatal birth weight).Results (1),The utilization rate were 92%(23/25)in cryopreserved-thawed testicular spermatozoa and 100%(12/12)in epididymal spermatozoa.(2)Between fresh and cryopreserved-thawed groups,no statistical difference was observed in two pronuclear fertilization rate[62.25%(973/1563)vs.64.53%(282/437),P=0.960],high quality embryo rate[78.9%(768/973)vs.79.1%(223/282),P=0.985],clinical pregnancy rate per embryo transfer[44.4%(60/135)vs.46.9%(15/32),P:0.688]and embryo implantation rate[29.3%(84/287)vs.33.3%(23/69),P=0.508].(3)No significant difference between flesh and cryopreserved group was found in spontaneous miscarriage rate (11%vs.7%,P＝1.000),gestational weeks(single birth:39.0 weeks vs.38.7 weeks,P:0.538;twins:36.8 weeks vs.36.3 weeks,P=0.571)and birth weight(single birth:3409 g vs.3350 g,P=0.699;twins:2584 g vs.2635 g,P=0.703).Conclusion It suggested that tissue from the azoospermic patients who underwent diagnostic testieular and epididymal biopsy should be eryopreseved for IVF-ET.

OBJECTIVETo observe the effect of gastric dynamics by transcutaneous electrical acupoint stimulation (TEAS) combined general anesthesia when controlled hypotension dropped to 60% of the mean arterial prenssure (MAP) baseline, and to provide experimental evidence for organ protection in clinical controlled hypotension.

METHODSEighteen male beagles were randomly divided into three groups, the general anesthesia group (blank), the general anesthesia induced controlled hypotension group (control), and the general anesthesia combined TEAS induced controlled hypotension group (experiment), 6 in each group. Controlled hypotension was performed in the latter two groups with isoflurane inhalation and intravenous injection of sodium nitroprusside (SNP). The mean arterial pressure (MAP) was lowered to 60% of the MAP baseline and kept for 60 min. Controlled hypotension was not performed in Beagles of the control group. For Beagles in the experiment group, TEAS [2/100 Hz, (4 ± 1) mA] was applied to bilateral Hegu (LI4), Quchi (LI11), Zusanli (ST36), and Sanyinjiao (SP6) from stable physiological conditions to the end of maintaining stages. Changes of EGG frequencies and EGG amplitudes were monitored. Serum levels of gastrin (GAS) and motilin (MTL) were also detected at corresponding time points during and after experiment.

RESULTSAs for the pressure control effect of TEAS combined general anesthesia in the controlled hypotension, during the process of controlled hypotension (T1-T4), MAP levels of two controlled pressure groups remained relatively stable, and were kept at 60% of the MAP baseline. When the blood pressure dropped to the target low MAP and maintained at 60 min (T1-T4), EGG amplitudes of Beagles in all the three groups showed decreasing tendency. But it was more obviously lower than its basic level in the control group (P <0.05), while it was not obviously decreased in the experiment group (P < 0.05). EGG frequencies of Beagles in all the three groups showed no obvious change during this stage. By the end of the MAP rising stage (T8), the EGG amplitude of the experimental group was significantly higher than that of the control group and the blank group (P < 0.05), while it didn' t show any obvious increase in the control group. During this period, EGG frequencies of the two controlled hypotension groups decreased more than those of the blank group. Two h after rising blood pressure (at T9), EGG amplitudes and frequencies in the two controlled hypotension groups basically restored to their respective baselines and levels of the blank group at T9. At 2 h (T9) after controlled hypotension, serum levels of GAS and MTL were lower than those of basic levels in the two controlled hypotension groups (P <0.05). However, serum levels of GAS and MTL had an increasing trend in the two controlled hypotension groups at 24-72 h (T10-T12). Besides, the increasing speed and amplitude was better in experiment group than in the control group at T10-T12. However, there was no statistical difference between the two groups (P > 0.05). At 72 h (T12) serum levels of GAS and MTL had basically restored to their basic levels in the two controlled hypotension groups and that of the blank control group.

CONCLUSIONEGG amplitudes could be effectively improved in TEAS combined general anesthesia for controlled hypotension at 60% of the MAP baseline, the recovery of the serum GAS level accelerated, gastric power improved and stomach protected.

Acupuncture Points ; Anesthesia ; methods ; Anesthesia, General ; Animals ; Arteries ; Dogs ; Gastrins ; Hypotension, Controlled ; Male ; Motilin ; Nitroprusside ; Transcutaneous Electric Nerve Stimulation

AIMTo Investigate the effect of glutamate (Glu) and gamma-aminobutyric acid(GABA) in orbitofrontal cortex (OFC) on regulation of gastric motility.

METHODSUsing microinjection in OFC,together with lesion of related nucleus,and recording the intragastric pressure(IGP).

RESULTS(1) Microinjection of Glu in OFC caused a significant reduce of the amplitude of gastric motility, this effect could be reverse by lesion of amygdala, while lesion of LC had no influence on the effect of Glu. (2) microinjection of GABA in OFC could increase the amplitude of gastric motility significantly,and lesion of LC could abolish this effect,while lesion of amygdala could enhance the effect of GABA more.

CONCLUSIONMicroinjection of Glu in OFC may enhance the normal inhibitory effect of amygdale on gastric motility, and the effect of microinjection of GABA in OFC on gastric motility is closely related with LC.

Amygdala ; physiology ; Animals ; Female ; Frontal Lobe ; metabolism ; physiology ; Gastrointestinal Motility ; drug effects ; Glutamic Acid ; pharmacology ; Locus Coeruleus ; physiology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; gamma-Aminobutyric Acid ; pharmacology

Cholesterol ester transfer protein (CETP) is a key regulator of high density lipoprotein (HDL). Owing to its important role in the reverse of cholesterol transport, CETP has become a hotspot target in modulating lipid drug design. In this paper, structure based pharmacophore (SBP) models for CETP inhibitors were built based on the protein structure 4F2A from Protein Database (PDB). The best pharmacophore contained six hydrophobic features, one hydrogen bond acceptor feature and nine excluded volume features, with the N and CAI value was 3.33 and 2.31 respectively. Then the model was used to search the traditional Chinese medicine database (TCMD) and 629 compounds originated from 315 TCM herbs were obtained. Molecular docking was also used to validate SBP by analyzing the critical amino acid residue and the interaction between potential active compounds and receptor. In this study, several TCM herbs, like Lycii Frutus and Schisandrae chinensis fructus, which contained more optimal SBP based screening results, have been reported hypolipidemic effect, and need to be studied deeply in a more focused research on herbal active constituents. Therefore, this study could provide reliable fundamental data for exploring the action mechanisms of TCM, and be applicable to identify lead candidates, which can be utilized as starting scaffolds for natural CETP inhibitors.
Cholesterol Ester Transfer Proteins ; antagonists & inhibitors ; Drug Evaluation, Preclinical ; methods ; Medicine, Chinese Traditional ; Molecular Docking Simulation