Objective To observe the clinical features of pulmonary infections secondary to lung tuberculosis and explore the nursing care strategy in this condition.Methods Retrospective analysis on in patients of lung tuberculosis with secondary pulmonary infections from Sep 2000 to Aug 2002.Results Of 53 tuberculostic patients who were suffered from lung infection after hospitalization,majority were secondary tuberculosis including chronic fibrosis with cavity information in 21 cases and exudative in 17 cases while other typies like miliaris disseminata in 14 cases.Total mortality was 11.3%.Conclusion Intensive and specific nursing care could reduce the prevalence of nonsocasimal infection in tuberculostic in-patients and improve the outcome.

Objective To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in the treatment of early acute respiratory distress syndrome(ARDS) Methods 12 patients with early ARDS were errolled in the study All the patients pulltiled the criteria of ARDS and no improvement after high flow oxygen therapy via mask NIPPV was used because the patients and their family refused intubation Pressure support ventilation (PSV) and positive end expiratory pressure (PEEP) were used via facial mask with Vison or BiPAP ventilator PEEP were set at 8～12 cm H 2 O with 4～6 PSV level Results The baseline respiratory frequency(RR)was (36?4)bpm,PaO 2 was (55?9)mm Hg and oxygen index (OI)was (127?4)mm Hg At final,8 patients survived (S group) and 4 patients died (F group) After 4～6 h treatment with NIPPV,in S group,RR decreased to (32?1 2)bpm ( P

Objective To explore the effect of Bacillus Calmette guerin vaccine (BCG) on apoptosis of lymphocytes in asthmatic BALC/c mice Methods Asthmatic BALB/c mice model established by inhaling ovalbumin was treated by BCG Lymphocytes apopotic index and DNA damage index were determined by comet method and xylidine method,respectively Results Apoptosis index and DNA damage percentage of peripheral blood and BALF lymphocytes were significantly elevated after BCG treatment( P

Objective To investigate the expression difference of multidrug resistance and apoptosis related genes and its contribution to mechanisms of multidrug resistance in human lung adenocarcinoma parental cell line A 549 and cisplatin resistant cell line A 549 DDP Methods RT PCR and Immunohistochemical staining were performed to detect the mRNA expressions and protein production of multidrug resistance related protein (MRP),lung resistance protein (LRP),bcl 2,and C erbB 2 in A 549 and A 549 DDP .Results MRP,bcl 2,and C erbB 2 mRNA were expressed in A 549 ,but no LRP mRNA was detected in A 549 MRP,C erbB 2,and LRP mRNA expression levels in A 549 DDP were significant higher than those in A 549 ,otherwise,LRP mRNA was detected in A 549 DDP There was no difference of bcl 2 mRNA expressions between A 549 and A 549 DDP ( P =0 731) Bcl 2 protein expressions were strongly positive both in A 549 and in A 549 DDP MRP protein expressions in A 549 were faint positive,while C erbB 2 and LRP were negative MRP protein expressions in A 549 DDP was median positive C erbB 2 and LRP protein expressions in A 549 DDP were strongly positive Conclusions The heterogenous expression of MRP,C erbB 2,and LRP in A 549 and A 549 DDP may be associated with primary and secondary drug resistance in lung cancer

Objective To investigate the differential diagnostic values of DNA analysis for malignant and tuberculosis pleural effusion by flow cytometry (FCM), and compare with CEA assay MethodsUsing FCM to detect DNA aneuploidy in malignant and tuberculostic pleural effusion Results Both the specificity and diagnostic index of DNA analysis were better than CEA( P

Objective To investigate whether pulse pressure variation (△PP) reflect the effects of PEEP and fluid resuscitation (FR) on hemodynamic effects.Methods Twenty critical patients with acute lung injury was ventilated with volume control (VT =8 mL/kg,Ti/Te = 1: 2) ,and PaCO2 was kept at 35 to 45 mm Hg.PEEP was setted as 5 cm H2O and 15 cm H2O in randomized order.Hemodynamic parameters including cardiac index, pulse pressure, central venous pressure, etc.were monitered by PiCCO system.Measurements were performed after the application of 5 cm H2O PEEP (PEEPs group)and 15 cm H2O PEEP (PEEP15 group) respectively.When the PEEP-induced decrease in cardiac index (CI) was > 10%, measurements were also performed after fluid resuscitation.Results Compared with PEEPs group, CI was decreased significantly in PEEP15 group(P < 0.05), and APP was increased significantly (P < 0.05).In 14 patients whose PEEP-induced decrease in CI was > 10%, fluid resuscitation increased CI from (3.01±0.57)L · min-1· m-1to (3.62±0.68)L · min-1 · m-2(P<0.01),and decreased △PP from (17±3)% to (10±2) % (P < 0.01).PEEP15-induced decrease in CI was correlated negatively with APP on PEEP5 (r =-0.91,P < 0.01) and with the PEEP15-induced increase in △PP (r =-0.79, P < 0.01).FR-induced changes in CI correlated with APP before FR (r = 0.96, P < 0.01) and with the FR-induced decrease in APP (r =-0.95, P < 0.01).Conclusions In ventilated patients with ALI, △PP may be a simple and useful parameter in predicting and assessing the hemodynamic effects of PEEP and FR.

Objective To evaluate the effects of selective serotonin reuptake inhibitors (SSRIs) on sleep apneas in Sprague-Dawley (SD) rats.Methods Thirty adult male SD rats were randomly divided into two groups (15 rats in each group).The treatment group and the control group were injected intraperitoneally with paroxetine (10 mg · kg-1·d-1) and sterile distilled water (2 mL · kg-1 · d-1) for 7 days respectively.Parameters about sleep apnea and sleep structure were measured before and after the treatment.Results In the treatment group, there was a significant reduction of apnea index (AI) from (12.4±3.7) times/hour to (7.4±2.2) tmes/hour (P = 0.000).Both post sigh apnea index (PSAI) and spontaneous apnea index (SPAI) were decreased significantly (P = 0.000 and 0.021 respectively) in non-rapid eye movement (NREM) sleep, but not in REM sleep.REM sleep was reduced from 8.6% to 8.0% (P = 0.013) and its latency was increased from (54.1±48.4) rain to (110.9±43.4) min (P = 0.001) in the treatment group,as well as the sleep-onset latency [from (20.7±9.1) rain to (30.0±15.7) rain, P = 0.038].Conclusion Paroxetine can reduce sleep apneas in SD rats during NREM sleep.Its effects on sleep structure include reducing REM time,increasing REM latency and sleep-onset latency.

Objective To develope a novel rabbit carotid body and carotid common artery model in vivo for the simulation of various intermittent hypoxia (IH) intensities, IH durations, IH reoxygenation (ROX) durations and continuous hypoxia (CH) modes.Methods Forty-five adult New Zealand rabbits (2.5～3.0 kg) were anesthetized while spontaneous breathing kept intact.The tissue surrounding the fight earetid common artery and carotid sinus nerve (CSN) were cleared and "single" chemoreceptor bundle of the CSN was revealed.Then suction electrodes were placed and CSN afferent activity was monitored and recorded carefully.The fight common carotid artery was exposed, cannulated to distal part and its proximal part was ligated.Preparations were challenged by changing the PO2 of the gas mixture equilibrating the perfusate.Alternatively perfusion (2 mL/min) of equilibrated porfusate bubbled with normoxia or hypoxia gas mixtures formed IH/ROX cycles in carotid common artery,simulating the pattern of hypoxic episodes seen in obstructive sleep apnea syndrome (OSAS), or with continuously perfusing hypoxia perfusate to form CH modes.All the perfusing procedures were regulated by a customized computer-controlled set and monitored using O2 gas analyzer.After the systematic exposures, carotid body, carotid common artery part distal to cannula,and carotid bifurcation were harvested as samples.Results The frequencies and average amplitudes of CSN chemoreceptor bundles afferent activities with normoxia peffusion were (0.17±0.03) impulse/s and (46.2±4.4) μV, and with hypoxia perfusion were (0.6±0.09) impulse/s and (87.4±6.6) μV, respectively.PO2 was (139±1.5) nun Hg in normoxia perfusate and (35.2±1.3) mm Hg in hypoxia perfusate.Conclusion This new carotid body and carotid common artery model is a valuable tool to study neurological and biochemical changes in various IH and CH modes.

Objective To investigate the changes and significance of serum inflammatory factors in coronary heart disease (CHD) patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) ,and the treatment effects of continuous positive airway pressure (CPAP).Methods A total of 76 CHD patients in Renmin Hospital of Wuhan University from October 2007 to October 2008 were enrolled.Polysomnography (PSG) was performed in these CHD patients to identify if they were complicated by OSAHS.The levels of inflammatory factors including TNF-α, IL-6, high sensitive C-reactive protein (hs-CRP) in serum were determined in the CHD patients and 23 normal subjects.The CHD patients with mederate-severe OSAHS (AHI≥ 15 episodes/hour) were treated by Auto-CPAP for 3 months and all parameters above were measured again.Results There were 41/76 (53.9%) of CHD patients had mederate-severe OSAHS and were treated with CPAP.The levels of TNF-ct,IL-6 and hs-CRP were significantly higher in the CHD patients than those in the normal controls (all P <0.01) ,and were significantly higher in moderate-severe OSAHS patients than those in the non-OSAHS CHD patients.Auto-CPAP ventilation significantly decreased the levels of inflammatory factors in the CHD patients with moderate-severe OSAHS.Conclusions An obvious proinflammatory state is detected in CHD patients ,and is aggravated with OSAHS.CPAP is a useful treatment for CHD patients with mediate to severe OSAHS.

Objective To study the relationships among health-related quality of life(HRQL), social support, excessive daytime sleepiness (EDS) and PSG parameters in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods Eighty-five patients were recruited who were diagnosed as OSAHS by overnight po]ysomnography from August 2007 through November 2007 in West China Hospital.The Calgary sleep apnea quality of life index (SAQLI) was used for HRQL, social support rating scale (SSRS) was used for social support,and Epworth sleepiness scale(ESS) was used for EDS.The Pearson linear correlation and stepwise multiple regression analysis were used to analyze the correlation among SAQLI, SSRS, ESS, and PSG.Results The SAQLI was correlated with SSRS score (r = 0.402, P < 0.01) ; ESS score (r =-0.505 ,P <0.01) ; apnea-hypopnea index (AHI) (r =-0.269,P <0.05) and lowest artery oxygen saturation (ISaO2) (r = 0.226, P < 0.05).Stepwise muhiple regression analysis determined two variables,the SSRS and ESS score,as independent factors for predicting the total score of SAQLI which accounted for 37.3% of the total variance in the total score on SAQLI (R2 = 0.373, P < 0.001).Conclusions The HRQL of patients with OSAHS was correlated with the SSRS score, ESS score and PSG parameters.The former two were the more important factors to affect the HRQL of patients with OSAHS.