Objective To investigate the impact of relevant factors in mechanical ventilation on intraabdominal pressure in patients with ALI/ARDS by continuous monitoring of intra-abdominal pressure.Methods A total of 116 ALI/ARDS patients treated with mechanical ventilation in ICU were enrolled in this study.Intra-abdominal pressure (IAP) was recorded continuously.Meanwhile ventilator parameters, arterial blood gas analysis, hemodynamic variables, and as well as the levels of IL-4, IL-8 and TNF-α in blood and bronchial alveolar lavage fluid (BALF) were determined and recorded.The detection of risk factors for intra-abdomen hypertension (IAH) were carried out using multivariate stepwise logistic regression.ROC curve analysis used to estimate the diagnostic performance of these parameters for IAH.Results The oxygenation index (PaO2/FiO2) in patients with IAH after 2 hours' mechanical ventilation was significantly lower than that in patients with normal intra-abdomen pressure (IAP) (P ＜ 0.01);PEEP and RR in mechanical ventilation were higher in IAH group (P ＜ 0.01 or P =0.001);Mean artery pressure (MAP), ejection time percent (ET), stroke volume (SV), cardiac index (CI) were lower in IAH group than those in normal IAP group (P ＜ 0.01);the levels of IL-4, IL-8 and TNF-α in blood and bronchial alveolar lavage fluid were higher in IAH group than those in normal IAP group (P ＜ 0.01);IAH patients have a higher mortality on 28 d (Log rank test, P =0.023).Poor oxygenation index (PaO2/ FiO2) after 2 hours' ventilation, high PEEP setting, low MAP, ET, SV, CI and elevated IL-4 in the BALF were resulted in increasing risk of IAH for ARDS patients under mechanical ventilation support.Conclusions The monitoring of intra-abdominal pressure should be emphasized for ALI/ARDS patients when mechanical ventilation was employed.PaO2/FiO2, SV and IL-4 in BALF might be the independent risk factors of IAH.

The manuscript introduced the overview, training objectives, policy advantages, training process,curriculum, examination of the Australian College in Rural and Remote Medicine and further contrasted that with China's domestics.The authors held that Australia's training is better targeted due to its colleges tailored to this end;the training duration for general practitioners of rural and remote areas is longer,and the training schedule is reasonable;the curriculum design and training content are more targeted;and the homogeneous training is better achieved as its examination is run by the college in a standardized manner.The authors therefore hold that China should develop detailed regulations for general practitioners from rural and remote areas and explore the feasibility of setting up second-level disciplines institutes for internal medicine, surgery, gynecology and obstetrics, pediatrics and general at national and provincial level.

ObjectiveTo investigate the effects of photodynamic therapy(PDT) on the activity and structure of the dental plaque biofilm formed by the main cariogenic bacteria.MethodsS.mutans,S.sangius,L.acidophilus and A.viscosus were chosen as the experimental bacteria to establish dental plaque biofilm model.They were separated into three groups:group of PDT、group of chlorhexidine and group of normal saline.The influence of the dental plaque biofilms was observed according to plate counting of bacteria method.The changes in the structure of biofilms after PDT were analyzed by means of confocal laser scanning microscopy.Results Compared to normal saline group,chlorhexidine cariogenic bacteria (CFU/ml) in plaque biofilms significantly reduced (P＜0.05),with the bactericidal rate 57.84％.After PDT treatment against artificial caries model,the number of cariogenic bacteria (CFU/ml) in plaque biofilms reduced more significantly (P＜0.05),the bactericidal rate up to 94.92％,and the structure of dental plaque biofilns changed evidently.ConclusionPDT is an effective method in eliminate cariogenic bacteria of dental plaque biofilms and to destroy the integrity of dental plaque biofilms,and it is a promising method for elimination of dental plaque and prevention of caries.

Objective To explore the clinical values of applying contact-mode argon plasma coagulation (APC) for retroflex colonoscopic treatment of ultra-lower rectal polyps. Methods 46 wide outsole and applanate polyps smaller than 1.0 cm located at ultra-lower rectum in 17 cases of patients were treated by contact-mode APC under U-type retroflex colonoscopy after failure in regular colonoscopic treatment. Then observe the contacting rate of APC probe with polyps, success rate of curing polyps, rate of probe being adhered and blocked by the solidification structures, incidence of submucosal emphysemas, and incidence of colonoscope ambustion. Results Under U-type retroflex colonoscopy, the probe could contact with polyps in 17 patients. The polyps in every patient were cured by APC in the first time of colonoscopic treatment, whereas all 46 polyps were cured by 97 times of APC spurt. Mild adhesions occurred between the probe and solidification structures at 5 times (5.15 %) among 97 times of APC spurt, without injuries to the coagulation surface from which when the probe separated. The solidification structures blocked the probe only twice (2.06 %). When the solidification structures were cleared, efficiency of the probe restored. No sub-mucosal emphysemas and colonoscope ambustion happened. Conclusion Applying contact-mode APC for retroflex colonoscopic treatment of ultra-lower rectal polyps is safe and effective, it can prevent the damage of colonoscope from the argon knife.

To clear the kinds of trace elements which is closely related with the active ingredient, proclaim the effects of trace elements on the quality of the Glycyrrhizae Radix et Rhizoma, provide the theoretical foundation to the further quality control of cultivation, take the advantage of the HPLC to determine the contents of glycyrrhizic acid and the liquiritin according to Chinese pharmacopoeia, use the inductively coupled plasma mass spectrometry to test the contents of Cu, Zn, Mn, Pb, Se, Cd, Ni, La, Na, Cr, M, Fe, Ca, Al, K, Sr, then, use SPSS statistical software for active ingredient and trace elements Correlation Analysis. The result of correlation analysis showed that Liquiritin contents of Glycyrrhizae Radix et Rhizoma have strong a positive correlation with the Mn, Pb contents, well, have a negative correlation with the Cu, Na contents; Glycyrrhizic acid contents showed a positive correlation with Mg, Cd, La contents, however, it showed a negative correlation with K, Fe contents. Comprehensive analysis of the results of the study, a preliminary thought that the active ingredient of Glycyrrhizae Radix et Rhizoma closely related with the trace elements, but the exact conclusion still need further study concentration-response relationship analysis.
Chromatography, High Pressure Liquid ; Flavanones ; analysis ; Glucosides ; analysis ; Glycyrrhiza ; chemistry ; Glycyrrhizic Acid ; analysis ; Mass Spectrometry ; methods ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Trace Elements ; analysis

[Objective To explore the effect of problem-based learning(PBL) in biochemistry teaching in medical college. Methods Totally 128 students(2011 grade) of medical laboratory major were derived into experiment group(n=64)and control group(n=64). Lecture-based learning(LBL) was used in control group and PBL was used in experiment group.In control group,teachers did teaching design according to the needs of curriculum standards,employed multimedia courseware,explained the basic content of each chapter,class exercises and homework after class. In experimental group,PBL was conducted through establishing biochemistry teaching website based on school's teaching platform. Teach-ing process in experiment group included:grouping-selecting appropriate cases-consulting data-group discussing-summarizing by teachers. Theory test was carried out after the course and questionnaire was conducted for students in experiment group . Data were analyzed using the independent sample t test . Results Average test scores were higher in PBL group than in traditional group,with statistically signif-icant differences[(83.15±11.87)vs. (76.15±12.48)]. Questionnaire survey showed that more than 90.0%students in experiment group were interested in the PBL teaching method and thought that the PBL teach-ing method can enhance the enthu-siasm of learning, independent learning ability and comprehensive analysis ability. Conclusions PBL teaching method can improve the quality and the effect of biochemi-stry teaching and culture students' comprehensive ability. It is worthy of further study and popularization.

Powder X-ray diffraction (PXRD) technology combined with cluster analysis method was used to classify 75 batches of crystalline ceftriaxone sodium into subtypes, the crystalline characteristics of each subtype were measured with scanning electron microscope (SEM). By comparing some parameters of these subtypes correlated to crystallization process of ceftriaxone sodium, such as salification rate, water content in different subtypes, as well as by studying different lattice stabilities, different compatibilities with rubber closures during accelerated stability tests, the key point to improve the quality of domestic ceftriaxone sodium was disclosed. The results of this paper indicated that the fine structure of the products could be controlled well by improving the salification and crystallization process. As a result, the subtype II of ceftriaxone sodium with high stability can be produced.
Ceftriaxone ; chemistry ; classification ; Crystallization ; Microscopy, Electron, Scanning ; Powders ; Water ; X-Ray Diffraction

Exosomes, small vesicles of endocytic origin, have attracted attention in bone regeneration field. The vesicles travel between cells and deliver functional cargoes like proteins and RNAs, thereby regulating targeted cells dif-ferentiation, commitment, function, and proliferation. Exosomes directly regulate MSCs into the osteoblastic lineage, stimulate bone regeneration by directly regulating osteoblast proliferation and activity, regulate osteoclast maturation and activity and stimulate bone growth and regeneration by increasing vessel formation. Meantime, exosomes resolves toxicity and immunogenicity problems caused by biomaterial treatment. Furthermore, compared with living cell trans-plantation, exosomes present a lower risk for severe complication(such as tumors, emboli formation).

Objective To explore the clinical effect of traditional Chinese medicine (TCM) dialectical therapy for treatment of gastrointestinal dysfunction in patients with acute lung injury / acute respiratory distress syndrome(ALI/ARDS)undergoing mechanical ventilation. Methods A prospective,randomized controlled trial was conducted. Ninety-six ALI/ARDS patients admitted in intensive care unit(ICU)and treated with mechanical ventilation in Tianjin First Central Hospital were chosen and randomly divided into traditional Chinese medicine(TCM) group and conventional therapy group using a random number table,48 patients in each group. Conventional therapy alone was used in conventional therapy group,and TCM therapy of primarily using Dachengqi decoction combined with conventional therapy was applied in TCM group〔Dachengqi decoction was composed of mongolian milkvetch root 15 g, pilose asiabell toot 15 g,Chinese angelica 10 g,officinal magnolia bark 10 g,tangerine peel 10 g,immature tangerine fruit 10 g,peach seed 10 g,white peony root 12 g,red peony root 12 g,immature bitter orange 6 g,mongolian dandelion herb 30 g,radish seed(stir-fried)30 g,foxtail millet sprout 20 g,barley sprout 20 g,glauber salt 9 g (with water),rhubarb 10 g(added in water at last)〕,one dose orally taken daily for 28 days. The intra-abdominal pressure(IAP),gastrointestinal diseases in TCM symptom score and the incidence of gastrointestinal dysfunction were compared between the two groups before treatment and on the 3rd,6th and 8th day after treatment. Results There were no statistical significant differences in IAP and TCM symptom scores between the two groups before treatment (both P>0.05),but after treatment with the prolongation of therapeutic time the IAP and TCM symptom scores were decreased gradually compared with those before treatment,having reached the valley value on the 18th day and the changes in TCM group were more remarkable〔IAP(mmHg,1 mmHg=0.133 kPa):0.91±0.69 vs. 2.08±0.92, TCM symptom score:48.33±10.41 vs. 88.33±20.21,both P<0.05〕. In the TCM group,the incidences of the untoward symptoms and signs of gastrointestinal dysfunction such as bleeding of stress ulcer,toxic intestinal paralysis, abdominal distension,diarrhea and so on were lower than those in conventional therapy group〔stress ulcer bleeding:16.7%(8/48)vs. 39.6%(19/48),toxic intestinal paralysis:16.7%(8/48)vs. 43.8%(21/48),abdominal distension:10.4%(5/48)vs. 37.5%(18/48),diarrhea:6.3%(3/48)vs. 33.3%(16/48),all P<0.05〕. Conclusion Addition of TCM Dachengqi decoction on conventional treatment can effectively lower the incidence of gastrointestinal dysfunction in treatment of patients with ALI/ARDS undergoing mechanical ventilation.

Objective To explore the effect of low constant direct current (LCDC) in the medullary cavity on repairing of rabbit radial defect as to evaluate its clinical value. Methods DBX was put into the segmental osteoperiosteum defect of rabbit bilateral radius. The rabbits were divided into 2 groups: group A (subject group) with the defects stimulated by LCDC and group B (control group) with the defects left untreated. In week 2,5 and 9, 4 animals from each group were put into death, and the radius was taken for study using photograph, electron microscope, histological & morphologic technique, and the contents of the Calcium (Ca) and ALP were determined. Results Compared with group B, the healing of group A was better. The contents of Ca and ALP increased obviously in week 2 (P