[Abts ract] Ven tilato r-associated pneumonia ( VAP) is one fo the most common nosocomila infec-tions of mechanically ventilated children in PICU.VAP not only contributes to prolong ed hospital and PICU lengt h of stay,but asl o icn reaseds medical cost,mortality and mo rbility in critiac lly ill children.It′s an urgent task to prevent VA P in pediatrici ntensive care medicine.The aimo f the articel was to intor duce the epidemi-ology,risk factors,prevention strategya nd practice in children.The article reviewed guidelines of strategies to prevent VAP in pediatric patients.

Objective To observe the changes of plasminogen activator inhibitor-1(PAI-1)mRNA expression in experimental lung iniury and to evaluate the effect of inhaled nitric oxide(NO)on PAI-1 mRNA expression.Methods In this study,acute lung injury rat model was established by lipopolysaccharide(LPS)-induced endotoxemia followed by a second LPS attack via intratracheal injection.Eighty-nine SD male rats aged 4～5 week were randomly assigned to three groups:saline control(C-A)group,LPS-A group attacked by LPS,LPS-NO group treated by nitric oxide.Realtime PCR was used to study the expression of PAI-1 mRNA in the lung.Histopathological lung injury score was evaluated.Results In LPS group,the histopathological lung injury score values were significantly higher than that of C-A group at 2 h[(3.10±0.38)vs(1.12±0.84)](P＜0.05)and the score values after 2 h were higher than that of LPS group at 2 h(P＜0.05).PAI-1 mRNA in lung increased gradually in LPS groups at 2 h,4 h,8 h,16 h,24 h(P＜0.05)and decreased at 48 h(P＞0.05).The PAI-1 mRNA decreased in LPS-NO groups at 4h(P＜0.05).Conclusion The study above demonstrates that PAI-1 mRNA expression is early elevated in rats with endotoxin-induced acute lung injury.Decreased PAI-1 mRNA expression is associated with the efficacy of inhaled nitric oxide.

At present,the satisfaction of free medical care of undergraduate is declining,and the doctor-patient relationship is becoming tense.By investigating and interviewing the three representative universities in Beijing,we conclude three reasons including the supplier of medical service,the receiver and doctor-patient communication.By adhering to the medical treatment concept of"Patient-Oriented",the paper puts forword serveral measures including incresing input and improving system and so on to achieve the harmonious development of doctor-patient relationship of undergraduate.

Objective To explore the effects of inhaled nitric oxide(NO) on expression of plasminogen activator inhibitor-1 (PAI-1) mRNA and protein in the early-stage of experimental acute lung injury (ALI) in a rat model.And to investigate the relationship between endogenous NO system including inducible nitric oxide synthase (iNOS)and intrapulmonary NO production and expressions of PAI-1 in ALI.Methods In the study,endotoxemia followed by the second attack due to intratracheal injection of lipopolysaccharide (LPS) in rats caused ALI.Male SD rats aged 4-5 weeks (clean conventional rats,180-200 g) were randomly assigned to 2 groups:saline control (C) group,LPS-treated (LPS) group,and the 2 groups were randomly allocated to subgroups exposed to air (A) or 20 × 10-6 NO.They were sacrificed for 24 h.Expressions of PAI-1 mRNA of the lung tissue were evaluated by real-time polymerise chain reaction; PAI-1 proteins were determined by immunohistochemistry.NO production in the lung tissues and pulmonary iNOS activity were measured.Meanwhile,histopathological lung injury scores were evaluated and modified martius acid fuchsin brilliant blue(MSB) stains was performed to evaluate fibrin of the lung tissues.Results At 24 h time point with intervention of iNO,PAI-1 mRNA and protein levels in LPS-NO subgroup were decreased compared with those in LPS-A subgroup (4.94 ± 0.52 vs 5.56 ± 0.27 ; 1.31 ± 0.40 vs 1.69 ± 0.16,all P ＜ 0.05).Meanwhile,iNOS activity and NO productions in LPS-NO subgroup were lower than those of LPS-A subgroup [(0.84 ± 0.36) U/mg prot vs (2.30 ± 0.25) U/mg prot ; (1.90 ± 0.84) μmol/g prot vs (3.38 ± 0.73) μmol/g prot,all P ＜ 0.05].iNOS activity had significant correlation with expression of PAI-1 mRNA and protein in lung tissue (r =0.481,P =0.005 ; r =0.667,P =0.000) ; NO production had significant correlation with expression of PAI-1 mRNA and protein in lung tissue(r =0.532,P =0.002; r =0.784,P =0.000).At 24 h time point,the histopathologic lung injury scores in LPS-NO subgroup were decreased in contrast to LPS-A subgroup (4.28 ±0.94 vs 6.12 ± 1.51,P ＜ 0.05).Fibrin deposition evaluated by modified MSB stains in LPS subgroups was found in alveolar space,lumen of blood vessel and mesenchymal ;LPS subgroup with NO appeared a decreasing trend in contrast to LPS subgroup with air.Conclusions Inhaled nitric oxide of 20 × 10 6 can suppress elevated expression of PAI-1 in ALI induced by endotoxin.This inhaled NO can improve the imba-lance of plasminogen activation system and alleviate lung injury.Meanwhile,inhaled NO down-regulates intrapulmonary iNOS activity as well as endogenous NO productions in rats with 2 hits of LPS induced ALI.These changes also have a close correlation with down-regulation of PAI-1 mRNA and protein.Thus,regulation of endogenous NO system on the expression of PAI-1 will be the future direction of new therapies for ALI.

OBJECTIVETo compare the efficacy difference among acupuncture smoothing-liver and regulating-spleen method, regulating Governor Vessel method and oral administration of western medicine for menopausal insomnia.

METHODSOne hundred and fifty-six cases of menopausal insomnia were randomized into a smoothing-liver and regulating-spleen group (group A), a regulating Governor Vessel group (group B) and a medication group (group C), 52 cases in each one. Acupuncture at Zhongwan (CV 12), Daheng (SP 15), Sanyinjiao (SP 6) and Taichong (LR 3), etc. was applied in the group A; acupuncture at Baihui (GV 20), Fengfu (GV 16), Shenting (GV 24) and Yintang (GV 29), etc. was used in the group B; oral administration of estazolam tablets (1 mg each-day) was adapted in the group C, all once a day for totally 30 days. The each item score and total score in Pittsburgh sleep quality index (PSQI) were evaluated before and after treatment in each group, also the efficacy in each group was assessed.

RESULTSAfter the treatment, the sleeping rate in the group A and B was significantly higher than that in the group C (both P < 0.05); the total effective rate in the Group A and B was also significantly higher than that in the group C [86.5% (45/52) and 82.7% (43/52) vs 63.5% (33/52), both P < 0.05; the total cured rate in the group A was significantly higher than those in the group B and C [48.1% (25/52) vs 23.1% (12/52) and 25.0% (13/52), both P < 0.05]. Each item score and total score of PSQI were all improved after treatment in the group A and B (P < 0.01, P < 0.05), while only sleeping time, sleeping efficiency and total score were improved in the group C (all P < 0.05). The sleeping quality, sleeping time, sleeping difficulty and daytime dysfunction in the group A were all lower than those in the group C (all P < 0.05). The sleeping quality, sleeping time and daytime dysfunction in the goup B were all lower than those in the group C (all P < 0.05). The total score in the group A was significantly lower than that in the group B and C (both P < 05).

CONCLUSIONAcupuncture has better effect for menopausal insomnia than estazolam. Between the two acupuncture methods, the acupuncture method of smoothing-liver and regulating-spleen has a better effect.

Acupuncture Therapy ; Female ; Humans ; Liver ; physiopathology ; Menopause ; physiology ; Meridians ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy ; Spleen ; physiopathology

Lipoxygenase(LO) pathway had been implicated in the pathogenesis of such cardiovascular diseases as hypertension, atherosclerosis, restenosis, and palys and important role in the development of these disease. LO inhibitiors could suppress vascular contractile responses significantly, reduce blood pressure, inhibit migration of vascular smooth muscle cells(VSMC), attenuate neointimal thickening in the injuried arteries and generation reactive oxygen species(ROS), block monocyte binding to VSMC, etc. The effects of LO inhibitors were associated with marked inhibition of MAPK pathway. Therefore, inhibition of LO pathway may provide a new strategy for preventing and treating above diseases, suggesting that LO mat be a novel taget for such purposes.

Epidemic influenza (flu) is a disease threatening the life of people for a long history.A precise forecast for the flu outbreak can warn and help health care providers to take measures to reduce the influences and harms in advance.At present,with the development of information technology,there have accumulated tremendous data of flu trends and climate information.With a history of 90 years researches about the forecast of flu trends,researchers have put forward different types of forecasting methods,and each of them has merits and demerits.Among these methods,those ones considering the key climate factors have higher precisions.Considering various methods at present,the prediction accuracy can be improved mainly from two aspects:on one hand,the forecast accuracy can be improved by effectively integrate the advantages of different models ; On the other hand,the prediction must take into account of the specific climate of an area,pathogens and the mode of transmission characteristics in order to determine the most relevant climate factors or other highly related factors with which to design a more reasonable and accurate prediction method.

Alzheimers disease is a progressive neurodegeneration disorder that is characterised by the accumulation of ? amyloid deposits and neurofibrillary tangles. It has been long assumed that the disrupted interneuronal communication that occurs in AD brain does not involve widespread changes in postsynaptic receptor function. However, recent evidence suggests that both the neurotransmitter receptor/G protein modulated adenyl cyclase and the phosphatidylinositol hydrolysis signal transduction cascades are disrupted in AD. Such disruption in AD may provide a reason for the relative lack of success of neurotransmitter replacement therapies for the disorder. Moreover it can direct drug research and development for AD treatment.

Nerve growth factor (NGF), one of the most potent growth factors for cholinergic neurons, has generated great interest as a potential target for the treatment of Alzheimers disease (AD). The degeneration of basal forebrain cholinergic neurons, which provides the major source of cholinergic innervation to the cerebral cortex and hippocampus, occurs early and contributes significantly to cognitive decline in AD. Those regions show high level expression of NGF and NGF receptors and depend on NGF for their survival and proper function. NGF executes its effects mainly by binding high affinity receptor TrkA in the remaining neurons of AD. Meanwhile, stimulation of neurons may protect those cells from the deleterious effects of AD, a phenomenon called “use it or lose it.”However, the use of NGF as therapeutic agent is limited by their hindered mobility through the blood brain barrier. Many theoretical and technical issues for NGF delivery to the target region in the brain remain to be solved, before NGF can live up to its potential for the treatment of AD.