Objective To observe the effect of lung suctioning method on mechanical ventilation related pulmonary infection of patients after cardiac valve replacement. Methods 102 patients of mechanical ventilation related pulmonary infection after cardiac valve replacement were randomly divided into the treatment group( 50 patients )and the control group( 52 patients ). The treatment group received intervention of lung suctioning method and the control group adopted routine sputum aspiration. The pulmonary infection rate and blood gas analysis before and after the treatment were observed and the cure rate and the positive rate of specimen of sputum were recorded. Results The pulmonary infection rate of the treatment group was lower than the control group;PaO2 and SaO2 were obviously different after treatment in the control group, but no difference in the treatment group. The cure rate of pulmonary infection patients in the treatment group was higher than those in the control group. Conclusions The intervention of lung suctioning method was a safe and effective method to improve hypoxemia and abate the rate of pulmonary infection.

Objective To investigate the effects of human umbilical mesenchymal stem cells (hUCMSCs) on Wistar rat models of stress urinary incontinence and its possible mechanism.Methods hUCMSCs cells were separated and extracted from human umbilical cord of cesarean delivery of full-term pregnancy women.The models of stress urinary incontinence (SUI) of Wistar rats were established by imitating delivery damage and ovary removing surgery,and then randomly divided into three groups:model group,transforming growth factor-β1 (TGF-β31) group,hUCMSCs group,and normal rats as normal group;and every group included ten rats.Maximal bladder capacity (MBC),leak point pressure (LPP),abdominal leak point pressure (ALPP),and sneezing experiment of rats including normal rats,model rats and model rats accepted TGF-β1 or hUCMSCs treatment were examined.When the treatment accomplished,the rats were killed and urethral sphincter were separated and examined by hematoxylin eosin (HE) staining and the proteins of troponin Ⅰ (TnI),troponin C (TnC),troponin T (TnT),tropomyosin (Tm),actin (AT),myosin heavy chain (MHC) and myosin light chain (MLC) of urethral sphincter was detected with Western blot method.Results The cells of hUCMSCs were extracted and authenticated,SUI models of Wistar rats were successfully established and authenticated.Compared to model group and TGF-β1 group,the MBC,LPP and ALPP of hUCMSCs group dramatically improved (P ＜ 0.05),while the positive rate of sneezing experiment significantly dropped (P ＜ 0.05).HE staining showed urethral sphincter became attenuation,fracture,sparse and disorder,simultaneously the proteins of TnI,TnC,TnT,Tm,MHC and MLC of urethral sphincter reduced (P ＜ 0.05).While the damaged urethral sphincter basically restored the normal structure and the proteins of TnI,TnC,TnT,Tm,MHC and MLC of urethral sphincter up-regulated through hUCMSCs treatment (P ＜ 0.05).Conclusions The treatment of hUCMSCs translation could observably improve the clinic symptoms of SUI Wistar rat models,and its mechanism may be related to enhancement of the protein expression of TnI,TnC,TnT,Tm,MHC and MLC of urethral sphincter,and were involved in the rehabilitation and reconstruction of urethral sphincter.

Objective:To investigate the effects of 7-difluoromethy-5,4:dimethoxygenistein (DFMG) on stress urinary incontinence (SUI) model in Sprague Dawley (SD) rats and its possible mechanisms.Methods:SD rat model of SUI was established through simulating pregnancy,birth trauma and ovarian castration.The rats were divided into a normal control group,a SUI group,and a DFMG group at 10 or 20 mg/kg.They were treated with 10 mg/kg normal saline (NS),10 mg/kg NS,10 mg/kg DFMG and 20 mg/kg DFMG,respectively,via gastric gavage every other day.Maximal bladder capacity (MBC),leak point pressure (LPP),abdominal leak point pressure (ALPP),hematoxylin-eosin (HE) staining,and Masson staining were performed to detect the index for the model.MiR-26b and its down-stream gene phosphatase and tensin homolog deleted on chromosome 10 (PENT) mRNA in urethral sphincter muscles cells (USMCs) were analyzed by RT-PCR.The protein levels of PENT,phosphatidylinositol 3-kinase (PI3K),protein kinaseB (AKT),B-cell lymphoma 2 (Bcl-2),Bcl-2 associated X protein (Bax),cytochrome C(Cyt-c) and caspase-3 were examined by Western blot.The apoptotic rate of USMCs was determined by flow cytometry (FCM),and the proliferative rate of USMCs was examined by MTT assay.Results:The SD rat model of SUI was successfully established.HE staining and Masson staining showed that the pathological features of urethral sphincter were improved in the DFMG-treated groups compared with the SUI group.The urine dynamics indexes of model rats,such as MBC,LPP and ALPP,were improved (all P＜0.05).The results of RT-PCR showed that the miR-26b mRNA was up-regulated (P＜0.05) and PENT mRNA was down-regulated (P＜0.05) in the DFMG-treated groups compared with the SUI group.Simultaneously,compared with the SUI group,the protein levels of PENT,Bax,Cyt-c and caspase-3 were down-regulated (all P＜0.05) and the protein levels of PI3K,AKT and Bcl-2 protein were up-regulated (all P＜0.05),accompanied by the decreased apoptotic rate of USMCs (P＜0.05) and the increased proliferative rate of USMCs (P＜0.05) in the DFMG-treated groups.Conclusion:The DFMG can significantly improve the symptoms of urinary dynamics,which might be related to the up-regulation of miR-26b expression and the regulation of PI3/AKT-Bcl-2/ Bax signaling pathways.

Objective To sum up the nursing experience of thrombolytic catheter of acute limb arterial embolism. Methods Reviewed and analyzed from January to December 2013, 38 cases of patients with acute limb arterial em-bolism in our hospital clinical data and nursing experience. Results Under the nursing intervention in patients with co-operate treatment actively, 29 patients with embolization artery completely opening, 9 cases of part. Clinical symptoms completely relieve the 31 cases, partial in 7 cases; 1 weeks after the inner psychological state, quality of life scores in every domains compared with admission, the difference was statistically significant (P < 0.01). Conclusion Catheter thrombolysis is an effective method for treatment of acute limb arterial embolism; Appropriate nursing intervention can effectively improve the patient's treatment adherence and confidence, to reduce the psychological problems, it is impor-tant to improve the therapeutic effect and quality of life of patients.

BACKGROUNDAn zidovudine (AZT)-substitution regimen containing 24-week stavudine (d4T) followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resource-limited settings. However, evidence is scarce. This study aims to assess the efficacy and safety of AZT-substitution regimen, aiming to find a regimen with better efficacy, less adverse events, and more affordability in resource-limited settings.

METHODSThis prospective, multicenter study enrolled 499 (190 on d4T regimen, 172 on AZT regimen, and 137 on AZT-substitution regimen) HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011. Lamivudine (3TC) and either nevirapine (NVP) or efavirenz (EFV) were the other two drugs in the antiretroviral regimens. Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4, 12, 24, 36, 48, 60, 72, 84, and 96.

RESULTSIn terms of hematological adverse effects, AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group. In comparison with AZT-substitution group, AZT group was associated with higher risk of developing anemia (adjusted hazard ratio (aHR) for anemia ≥ grade II, 8.44, 95% CI 1.81-39.46) and neutropenia (aHR for neutropenia ≥ grade II, 1.86, 95% CI 1.19-2.93). The prevalence of lipodystrophy in d4T group was 19.5%, while that in AZT-substitution group was zero. As to antiretroviral efficacy, these three groups showed no differences.

CONCLUSIONAZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings.

Adult ; Anti-HIV Agents ; administration & dosage ; adverse effects ; therapeutic use ; Female ; HIV Infections ; drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stavudine ; administration & dosage ; adverse effects ; therapeutic use ; Zidovudine ; administration & dosage ; adverse effects ; therapeutic use