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

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

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

OBJECTIVETo compare the difference in the clinical efficacy on premature ovarian failure (POF) between the acupoint catgut implantation combined with artifical periodic therapy and the simple artificial periodic therapy and explore its effect mechanism.

METHODSSixty-five patients of POF were randomized into the two groups. In a western medication group, 32 cases were treated with the artificial periodic therapy with the oral administration of medroxyprogesterone acetate tablets. In a catgut implantation + western medication group, 33 cases were treated with the acupoint catgut implantation combined with artificial periodic therapy. The acupoints of Neiguan (PC 6), Zusanli (ST 36), Guanyuan (CV 4) and Sanyinjiao (SP 6) were selected. The treatment was lasted for half a year and the follow-up visit was for another half a year in the two groups. Kupperman index was used to assess the improvements in the clinical symptoms. The levels of serum sexual hormones such as follicle stimulating hormone (FSH) and estradiol (E2) were evaluated of the patients in the two groups before and after treatment. The efficacy was compared between the two groups.

RESULTSThe scores of the clinical symptoms were all significantly improved after treatment and in the follow-up in the two groups (P < 0.01, P < 0.05). In the 6-month follow-up visit after treatment, the result in the catgut implantation + western medication group was better than that in the western medication group (8.17 +/- 1.19 vs 13.68 +/- 1.08, P < 0.01). FSH was reduced after treatment in the two groups (all P < 0.01) and E2 was increased (all P < 0.05). The curative and remarkably effective rates were 75.8% (25/33) and 81.8% (27/22) after treatment and in the follow-up visit in the catgut implantation + western medication group, which were better than 67.9% (19/28) and 53.6% (15/28) in the western medication group separately (P < 0.05, P < 0.01).

CONCLUSIONThe acupoint catgut implantation combined with artificial periodic therapy achieve the remarkable improvements in the clinical symptoms of POF in the patients and the better results as compared with the simple western medication therapy. The combined therapys efficacy is stable and the long-term efficacy is apparently superior. The effect mechanism is related to the improvements in the serum sexual hormone levels.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Catgut ; utilization ; Female ; Follicle Stimulating Hormone ; metabolism ; Humans ; Primary Ovarian Insufficiency ; metabolism ; therapy ; Prostheses and Implants ; Treatment Outcome ; 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

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

Cytometric bead array (CBA) is a new analytical technique, which can achieve real-time and rapid detection of targeted components in a small amount of sample. With many advantages of high throughput screening, high specificity and sensitivity, low cost, easy operation and good repeatability, this CBA technique has been widely used for the detection of various components in foods, agricultural products and environmental samples. Recently, it has got significant development in rapid detection of small molecules. This review briefly introduced the theory of CBA technique, summarized the application in the analysis of small molecules, such as mycotoxins, pesticide residues, shellfish toxins, and then prospected the application of trace small molecules detection in the complex matrices of traditional Chinese medicine and the development trend of it.
Drug Contamination ; High-Throughput Screening Assays ; instrumentation ; methods ; Immunoassay ; instrumentation ; methods ; Microspheres ; Pesticides ; analysis ; Toxins, Biological ; analysis

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