Objective: To study the rational treatment course of proton pump inhibitor omeprazole for critical patients in order to improve the prognosis and reduce the hospital stay and treatment expense. Methods:Totally 180 critical patients with APACHEⅡ>10 and mechanical ventilation >48 hours in ICU were selected and randomly divided into 3 groups treated by omeprazole for 1 day, 3 days and 5 days , respectively. The incidence rate of stress ulcer, gastrointestinal hemorrhage and ventilator-associated pneumonia ( VAP) in the three groups was studied, and the ICU stay and expense were also investigated. Results:The incidence rate of stress ul-cer and gastrointestinal hemorrhage in the group with treatment course of 3 days and 5 days were significantly lower than those in the group with 1 day treatment(P<0. 05). The incidence rate of VAP with 3-days treatment was the lowest, compared with 1 day and 5 days treatment, the different was satatistically significant(P<0. 05). The ICU hospitalization time and treatment expense were also significantly different among the three groups, and that in 3-days, group was the lowest(P<0. 05). Conclusion:The 3-day treatment is the most reasonable, which can not only prevent stress ulcer and gastrointestinal bleeding in critical patients, but also reduce the in-cidence of VAP with lowered hospital stay and expense.

Objective:To study the effect of omeprazole combined with glutamine in the prevention of stress ulcer. Methods:To-tally 106 cases of severe patients admitted in ICU of our hospital were divided into the observation group and the control group with 53 ones in each according to the admission order. The patients in the control group were treated with glutamine, and those in the observa-tion group were treated with sodium omeprazole combined with glutamine. The pH change in gastric juice, adverse reactions and inci-dence of stress ulcer after the treatment were observed and compared between the two groups. Results:After the 4-day treatment, the pH value of gastric juice in the observation group was significantly higher than that in the control group (P<0. 05), and after the 7-day treatment, the difference was more notable. After the treatment, the symptoms of upper digestive tract in the observation group were fewer than those in the control group (P<0. 05). After the treatment, the observation group had three stress ulcer patients with the incidence rate of 5. 66%, while that in the control group was higher (24. 53%), and the difference was statistically significant (P<0. 05). There was no statistically significant difference in the adverse reactions between the two groups (P>0. 05). Conclusion:Omeprazole combined with glutamine in the prevention of ulcers stress shows promising clinical efficacy, which can effectively inhibit gastric acid secretion and rapidly increase pH value of gastric juice with low incidence of adverse reactions, mild symptoms and high se-curity, and is worthy of wide use in clinics.

Aim To study the effect of artesunate on immuno-injured hepatic fibrosis induced by bovine ser-um albumin in rat model and the effect of artesunate on hepatic stellate cells ( HSCs ) proliferation, so as to provide experimental evidence for clinical application of artesunate and the treatment of hepatic fibrosis. Methods The model of immuno-injured hepatic fibro-sis induced by bovine serum albumin was established in Wistar rats. Rats were randomly divided into 5 groups:normal group, model group, low dose of arte-sunate, middle dose of artesunate and high dose of ar-tesunate. Drugs were given to the corresponding thera-peutic groups, and then were continued once a day for two months. Distilled water was given to the rats of normal and model groups according to the same meth-od. Liver tissues were used for measuring the content of collagen, the rat serum activities of albumin( Alb) , alanine aminotransferase ( ALT ) and aspartate amin-otransferase(AST). Liver tissue’ s pathological chan-ges were observed by HE and collagen staining. Isola-ted and cultured rat primary HSCs in the flask for 10 days to make cells activated, MTT assay was used to detect rate of cellular proliferation; concentration of hydroxyproline in supernatant was detected by digestive method; the expression of p53 was investigated by Western blot and RT-PCR. Results Serum levels of Alb in model group were significantly lower ( P <0. 05 ) , and levels of ALT and AST in model group were significantly higher ( P <0. 05 ) compared with normal group. Levels of AST in low, middle and high dose groups(3. 2, 9. 6, 28. 8 mg·kg-1 ) were signifi-cantly lower(P <0. 05) compared with model group, and levels of ALT in high dose groups were significant-ly lower(P<0. 01) compared with model group. The contents of collagen in model groups were significantly higher(P<0. 01) compared with normal group, while the contents of collagen in therapy groups significantly decreased ( P < 0. 05 ) compared with model group. Activated HSCs treated with various concentrations of artesunate (150, 175, 200 μmol·L-1 ) were inhibi-ted on dose and time-effect relationships. Production/secretion of hydroxyproline decreased after HSCs was treated by artesunate for 24 h; the expression of p53 was up-regulated showed by Western blot and RT-PCR in artesunate treated cells. Conclusion Artesunate brings about anti-fibrosis in vitro and in vivo by increas-ing the expression of p53 .