Home respiratory support for patients in the home care setting can range from simple oxygen supplementation, non-invasive ventilation, to home ventilation support via a tracheostomy. A home care doctor may not be able to know everything about ventilator support, but he should be familiar with the medical care of patients requiring one, and know who to refer to should patients require ventilator adjustments or troubleshooting. The management of such patients is challenging outside the hospital setting and usually requires a multidisciplinary team effort from the doctors, nurses, medical social worker, respiratory therapists, vendor of the ventilator and, most importantly, dedicated and well-trained caregivers. This article will cover two other important topics that Family Physicians should know when managing patients who require home respiratory support: home oxygen therapy and tracheostomy care.

Background The measurement of corneal Q value is essential for corneal refractive surgery and calculation of intraocular lens during cataract surgery.Topolyzer was often used for the measurement of Q value,and recently Topcon KR-1W and iTrace were applied in ophthalmology.However,whether the measured values are interchangeable is unclear.Objective This study was to assess the difference and consistency of corneal Q values measured by Topcon KR-1W,iTrace and Topolyzer.Methods Corneal Q values were measured on 100 right eyes of 100 healthy subjects under the approval of Ethic Committee of the Sixth Hospital Affiliated to Shanghai Jiaotong University and informed consent of each subject from November to December in 2014 with Topcon KR-1W,iTrace and Topolyzer.Three valid measurements were obtained for each device,and the average values from each device were calculated.The difference of the outcomes among the instruments was compared by repeated measures analysis of variance (ANOVA),and the consistency among the outcomes from different apparatus was analyzed by Bland-Altman plots.Results The mean corneal Q values were-0.184-±0.112,-0.117±0.167 and-0.269±0.117 from Topcon KR-1W,iTrace and Topolyzer,respectively,with a significant difference among them (P ＜ 0.001).The measured Q value by Topcon KR-1W was 0.085±0.010 larger than that by Topolyzer,and the Q values by iTrace was 0.152± 0.014 larger than that by Topolyzer,while the Q values obtained by Topcon KR-1W was 0.067±0.016 smaller than that by iTrace (all at P＜0.05).The 95％ confidence interval of the values between Topcon KR-1W and iTrace,Topcon KR-1W and Topolyzer,iTrace and Topolyzer were-0.106 to-0.028,0.060 to 0.109 and 0.118 to 0.186,respectively.Bland-Altman plots showed that 6％,6％ and 5％ values were outside of 95％ agreement of limit (LoA) between Topcon KR-1W and iTrace,iTrace and Topolyzer or KR-1W and Topolyzer,respectively,with the maximal differences of 0.28,0.43 and 0.38.Conclusions Corneal Q values measured by Topcon KR-1W and iTrace are larger than those measured by Topolyzer.Due to the poor agreements among the corneal Q values by the 3 kinds of devices,they are not interchangeable in clinical applications for the measurement of corneal Q value.

0.05).The activity of Na~+-K~+ ATPase in SMO group was significantly higher than that in HTK group at 72 h(P

Objective To explore the possible effect of Nogo-A receptor antagonist NEP1-40 on neurite outgrowth in neonatal rats with hypoxic-ischemic brain damage(HIBD).Methods Sixty-four healthy Wistar rats were randomly divided into 8 groups at 2 different time points(6 h,24 h):control group,HIBD group,NEP1-40 group and ganglioside group(GM-1 group).Rats of control group and HIBD group were injected with saline(0.25 mL/kg)by intraperitoneal injection,while rats of NEP1-40 group and GM-1 group were administrated with 10 mg/(kg?d) NEP1-40 and 20 mg/(kg?d) GM-1 on request in each group,respectively.Immunohistochemical staining was adopted to detect the Nogo-A-positive cells,and ultrastructural changes of neuron and axon were observed by transmission electron microscopy.SPSS 13.0 statistical software was used to run One-Way ANOVA tests on the data presented.Results The Nogo-A-positive cells at 2 time points in rats of HIBD group were significantly higher than those of control group(t=7.63,15.13 Pa0.05),while the Nogo-A-positive cells in GM-1 group at 24 h was lower than that of HIBD group(t=4.25 P

All kinds of traditional Chinese medicines (TCMs) differed from each other with different chemical components and properties. Owing to poor conditions and technologies, and the lack of scientific preservation, most TCMs will easily become mouldy during the processes of growth, harvest, handling, translation and especially storage, which will not only influence the quality, safety and efficacy of TCMs, but also cause serious waste and economic losses, and even do great harm to human health. The process of storage is closely related to the qualities of TCMs with many interference factors. Therefore, scientific preservation of TCM during storage is crucial to prevent them from being mouldy. This review analyzed the important harm of mouldy TCMs, summarized the internal and external factors of resulting in TCMs to become mouldy. Based on the above discussion, together with the characteristics and limitations of current TCM preservation techniques, we prospect novel, scientific and reasonable preservation techniques, expecting to provide references for scientific preservation of TCMs to avoid becoming mouldy and guarantee their qualities.
Drug Contamination ; prevention & control ; Drug Storage ; methods ; Drugs, Chinese Herbal ; chemistry ; Fungi ; growth & development ; isolation & purification ; Plants, Medicinal ; chemistry ; microbiology

Breast Neoplasms ; genetics ; Disease Susceptibility ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; Humans ; Mutation ; Ovarian Neoplasms ; genetics

OBJECTIVETo investigate the effect of nutrition protection on oxidation damage of the submarine men.

METHODS50 submarine men were randomly divided into test group and control group, 25 persons each. The test group member took VitB2 5 mg, VitC 200 mg, GPC capsule 50 mg, once every other day and VitA capsules 25 000 units for every week during the sea-voyage. The total anti-oxidative capacity (T-AOC), superoxide dismutase (SOD), malondialdehyde (MDA), the proliferation of peripheral-blood lymphocyte (PPL), the hemolytic degree of RBC and IFN-gamma were detected.

RESULTSBefore sea voyage, the difference in the T-AOC and SOD and PPL and IFN-gamma and the MDA content and the hemolytic degree of RBC between the test group and the control group were not significant (P>0.05). After sea voyage, the T-AOC and SOD and PPL and IFN-gamma in the test group [(24.08 +/- 0.10) U/ml, (44.85 +/- 0.96) U/ml, (0.29 +/- 0.05) (with H2O2), (0.34 +/- 0.04) (without H2O2) and (34.21 +/- 3.52) pg/ml] were higher than the control group [(21.06 +/- 1.10) U/ml, (42.80 +/- 1.46) nu/ml, (0.23 +/- 0.01) (with H2O2), (0.34 +/- 0.04) (without H2O2) and (31.89 +/- 3.52) pg/ml]. The MDA content and the hemolytic degree of RBC [(2.15 +/- 0.28) nmol/ml and (20.96% +/- 0.10%)] were lower than the control group [(2.44 +/- 0.32) nmol/ml and (23.12% +/- 0.77%)]. The difference was significant (P<0.05).

CONCLUSIONTo add antioxidant nutrients can improve the submarine men's antioxidant capacity.

Adult ; Antioxidants ; metabolism ; DNA Damage ; drug effects ; Humans ; Male ; Military Personnel ; Oxidative Stress ; drug effects ; Submarine Medicine ; Vitamins ; pharmacology ; Young Adult

Objective To study the effect of topiramate(TPM) on serum level of leptin and the expression of neuropeptide Y(NPY) in arcuate nucleus and their relationship with weight changes in pentetruzole-induced epileptic rats,and to explore the mechanism that TPM could reduce the weight.Methods One hundred and fifteen Wistar rats were randomly divided into 4 groups:blank control group,TPM contrast group,pentylenetetrazol(PTZ) model group,and TPM group.Weight changes were measured every 3 days.Serum leptin level was detected with rodioimmunity method and hypothalamic arcuate nucleus NPY expression was measured by immunohistochemical ABC technique at the 2~(nd),4~(th),6~(th) weekend,respectively.Results In TPM control group and TPM group weight loss appeared in the 4~(th) week compared with other groups at the 3~(rd) weekend and fell to the lowest at 4~(th) weekend(P

Objective To explore the roles of macrophage inflammatory protein-1?(MIP-1?)in hypoxic-ischemic encephalopathy(HIE)of newborn infarnts.Methods Serum samples were obtained in 24,72 h and 7 d after birth respectively from 34 newborn infants with HIE,and 20 newborn infants without HIE as control group.Enzyme-linked immunosorbent assay(ELISA)method was used to determine the serum concentrations of MIP-1?.Results Levels of MIP-1? in newborn infants with HIE [(12.47?2.51)ng/L]were significantly higher than that of newborn infants without HIE [(8.63?2.63)ng/L](P0.05).Conclusions MIP-1? are involved in HIE of neonates,and the more severe damage,the higher levels in serum,which suggests that,as an inflammatory mediator,the MIP-1? may play an important role in involvement of brain hypoxic-ischemic damage.

Objective To discuss the feasibility and curative effect of broncho-alveolar lavage(BAL)through bronchofiberscope in the treatment of severe toxic pulmonary edema caused by irritative gas.Methods 16 cases se- vere toxic pulmonary edema caused by irritative gas were performed BAL through bronchofiberseope.The index of oxygen in arterial blood,clinical and radiological changes before,during and 2 hours after BAL were observed.Results 2 hours after BAL through bronchofiberscope,the partial pressure of oxygen in arterial blood(PaO2)obviously in- creased,the partial pressure of carbon dioxide in arterial blood(PaCO_2)did not change much.PaO_2 and PaCO_2 had no obvious change before and during BAL.The shadow area in the X-ray film of chest obviously decreased 24 hours af- ter BAL.In all 16 cases,13 cases were cured,1 case got improvement,and 2 cases died.The curative rate was 81%. Conclusion BAL through bronchofiberscope could clear the noxious substance in airway and improve the ventilation function.It was safe and had confirmed curative effect.