Adult ; Aged ; Cause of Death ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; mortality ; Retrospective Studies ; Young Adult

Objective To explore the improvement method for blood collection via arteria radialis among elderly patientsMethods 188 patients were received radial artery puncture with tradtional way (92 cases) and allen way (96 cases). First puncture success rate and subjective feeling were compared between two ways. Results First puncture success rate of allen way was higher than that of traditional way (P<0.01). Pain of patients in alien way were lower than that of tradional way (P<0.01). Conclusions Mien way of radial artery puncture is better in first puncture success rate and subjective feeling of patients, and allen way is easy to master and is worthy generalization in clinical practice.

Objective To explore the reasons of patients undergone long-term mechanical ventilation in combination with airway granuloma and the nursing countermeasures. Methods The information of 15 eases undergone long-term mechanical ventilation in combination with airway granuloma in department of geriatric and respiratory were summarized and analyzed. Results The occurrence of airway granuloma was strictly related to local stimulation, nutrient deficiency and incision model. Condnsions The basic nursing should be strengthened agaisnt the above reasons, thereby reducing and avieding the occurrence of airway granuloma. The nursing measures adopted when the airway granuloma occurs also should be strengthened.

Objective Discuss the nursing interventions for reducing the VAP incidence for aged critical patients. Methods The clinical data of 148 patients of more than 65 years with mechanical ventilation (MV) were analyzed retrospectively. The incidence of VAP and the fatality rate were observed. Results 43 cases were confirmed with VAP in 148 patients, the incidence rate was 29.1%. 24 patients died from severe primary diseases or/and multiple organ failure. Conclusions For patients with mechanical ventilation, strict procedure, micromesh basic nursing were vital for prevention and reduction of the incidence of VAP.

Adult ; Air Pollutants, Occupational ; adverse effects ; Chemical Industry ; Female ; Humans ; Insecticides ; adverse effects ; Male ; Maximum Allowable Concentration ; Middle Aged ; Occupational Diseases ; chemically induced ; diagnosis ; Organothiophosphorus Compounds ; adverse effects ; Phosphorus Compounds ; adverse effects ; Sulfides ; adverse effects

Objective: To analyze the application value of heated humidifier and water humidifier of BiPAP ventilator in the treatment of type II respiratory failure. Methods: The clinical data of 50 patients with type II respiratory failure were statistically analyzed, and these patients were divided into heated humidifier group (adopted heated humidifier, n=25) and water humidifier group (adopted water humidifier, n=25) according to the difference of humidifying device of BiPAP ventilator. The PaO2, PaCO2, pH and the effect of humidifier for upper respiratory tract with dry sensation between pre-and post treatment were analyzed by statistical method. Results: The values of PaO2and pH of heated humidifier group were significantly higher than that of water humidifier group (t=4.303, t=3.182, P<0.05), respectively. While the PaCO2of heated humidifier group was significantly lower than that of water humidifier group (t=6.965, P<0.05). In the contrast of dry sensation of upper respiratory tract, the ratio of non-dry sensation in heated humidifier group was 84.0% (21/25) and it was 32.0% (8/25) in water humidification group, and the difference between the two groups was significant (x2=12.83, P<0.05). And the ratio of general dry sensation in heated humidifier group was 16.0% (4/25) and it was 40.0% (10/25) in water humidification group, and the ratio of heated humidifier group was significantly lower than that of water humidifier group (x2=5.02, P<0.05). Besides, the ratio of worst dry sensation in heated humidifier group was 0 and it was 28.0% (7/25) in water humidifier group, and the ratio of heated humidifier group was significantly lower than that of water humidifier group (x2=7.38, P<0.05). Conclusion: In the treatment of type II respiratory failure by using BiPAP ventilator, the application value and effect of heated humidifier is higher than that of water humidifier, so it is worthy to promote and use the heated humidifier in clinical practice.

The DNA fragments of ag85b、esat-6、hsp65、mpb64 and ag85b-esat-6、hsp65-esat-6、mpb64-esat-6 were amplified by PCR and SOE technique.These seven fragments were inserted into pCDNA3.1(+)vector to construct recombinant plasmids pCA、pCE6、pCH、pCM、pCAE、pCHE and pCME.The seven plasmids were transfected into SP2/0 cell in vitro to detect the expression of target genes.BALB/c mice were intramuscularly vaccinated with the seven plasmids and the control vector pCDNA3.1(+)and PBS respectively.The serum antibodies and the spleen lymphocyte proliferation(SLP)and secreted IFN～? of spleen were tested.The results of indirect ELISA showed the levels of antibodies in all recombinant plasmids groups were significantly higher than the two control groups(P

BACKGROUNDHelical tomotherapy (HT) is a new image-guided intensity-modulated radiation therapy (IMRT) technique. It is reported that HT plan for non-small-cell lung cancer (NSCLC) can give better dose uniformity, dose gradients, and protection for the lung than IMRT plan. We compared the dosimetric characteristics of HT for NSCLC with those of conventional IMRT to observe the superiority of HT.

METHODSThere was a comparative case series comprising 10 patients with NSCLC. Computed tomographic (CT) images of delineated targets were transferred to the PrecisePlan planning system (IMRT) and Tomo planning system (HT). The prescription doses were 70 Gy/33F for the gross tumor volume (GTV) and the visible lymph nodes (GTVnd), and 60 Gy/33F for the clinical target volume (CTV) and the clinical target volume of the visible lymph nodes (CTVnd). The dose restrictions for organs at risk were as follows: the maximum dose to spinal cord ≤ 45 Gy, V20 to the total lungs < 30%, V50 to the heart < 50%, and V55 to the esophagus < 50%. Both plans were evaluated by means of the dose coverage of the targets, dose-volume histograms (DVHs), and other dosimetric indices.

RESULTSThe dose coverage, conformity, and homogeneity of the targets' volumes were found to be satisfactory in both plans, but the homogeneity of the HT plan was better than that of IMRT. The high-dose radiation volume (V20-V30) to the lung and the mean lung dose (MLD) decreased (P < 0.05), but the low-dose radiation volume (V5-V10) increased slightly in the HT plan (P > 0.05). The maximum doses to the spinal cord, heart, esophagus and trachea in the HT plan were lower than those in the IMRT plan, but the differences were not statistically significant.

CONCLUSIONSThe HT plan provids better dose uniformity, dose gradients, and protection for the organs at risk. It can reduce the high-dose radiation volume for lung and the MLD, but may deliver a larger lung volume of low-dose radiation.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; radiotherapy ; Humans ; Male ; Middle Aged ; Radiography ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Treatment Outcome

Objective To study the effect of vitexin inhibiting Ras homology C(RhoC)/Rho-associated kinase(ROCK)signaling on lung inflammation and airway remodeling in rats with chronic obstructive pulmonary disease.Methods SD rats were divided into control group,model group(chronic obstructive pulmonary disease model),experimental-L group(chronic obstructive pulmonary disease model,1.5 mg·kg-1 vitexin treatment),experimental-M group(chronic obstructive pulmonary disease model,3.0 mg·kg-1 vitexin treatment),experimental-H group(chronic obstructive pulmonary disease model,6.0 mg·kg-1 vitexin treatment),experimental-H+LPA group(chronic obstructive pulmonary disease mode,6.0 mg·kg-1 vitexin,lysophosphatidic acid 1 mg treatment),Western blot detection of RhoC protein expression,detection of pulmonary function indexes in rats,hematoxylin-eosin staining to observe lung histopathology,and evaluation of airway inflammation in rats score,airway smooth muscle thickness,enzyme-linked immunosorbent assay method to detect interleukin-6(IL-6)content in bronchoalveolar lavage fluid,immunohistochemistry to detect basic fibroblast growth factor(bFGF)in lung tissue.Results The expression levels of RhoC protein in the control group,model group,experimental-H group,and experimental-H+LPA group were 0.25±0.02,0.71±0.09,0.31±0.03,0.47±0.04;forced vital capacity(FVC)were(8.25±0.62),(4.12±0.24),(7.21±0.54),(6.44±0.52)mL;inflammation score were 0.52±0.04,2.54±0.15,1.23±0.11,1.79±0.32;smooth muscle thickness were(19.28±1.52),(28.43±1.74),(19.45±1.18),(25.85±1.57)μm;IL-6 content were(2.40±0.08),(5.67±0.44),(2.85±0.23),(4.01±0.29)ng·L-1;bFGF protein expression were 0.19±0.02,0.52±0.05,0.24±0.02,0.43±0.05.There were statistically significant differences in the above indicators between the model group and the control group,between the experimental-H group and the model group,and between the experimental-H+LPA group and the experimental-H group(all P＜0.05).Conclusion Vitexin inhibits RhoC/Rock signaling to improve lung inflammation and airway remodeling in chronic obstructive pulmonary disease rats.

BACKGROUNDHelical tomotherapy (HT) is a new image-guided intensity-modulated radiation therapy (IMRT). The aim of this study was to evaluate the changes in the target volume and organs at risk (OARs) of patients with nasopharyngeal carcinoma (NPC) during helical tomotherapy.

METHODSForty-three patients with NPC and treated via HT from March 2008 to January 2010 were reviewed retrospectively. Repeated CT scanning and plan adaptation were conducted at the 20th fraction during radiotherapy. The volumetric differences between the two scans were evaluated for nasopharyngeal tumor and retro-pharyngeal lymph nodes (GTVnx), neck lymph nodes (GTVnd), and parotid glands, as well as the axial diameter of the head.

RESULTSThe median interval between the two scans was 25 days (23 - 28 days). The volumetric decrease in GTVnx was 30.1% (median, 29.8%) and in GTVnd 41.6% (median, 45.9%). The variation in the GTVnd volume was correlated with the weight loss of the patient. The volume of the left parotid gland decreased by 35.5% (median, 33.4%) and of the right parotid glands decreased by 36.8% (median, 33.5%). The axial diameter of the head decreased by 9.39% (median, 9.1%).

CONCLUSIONSThe target volume and OARs of patients with NPC varied considerably during HT. These changes may have potential dosimetric effects on the target volume and/or OARs and influence the clinical outcome. Repeated CT scanning and replanning during the HT for NPC patients with a large target volume or an obvious weight loss are recommended.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Child ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Organs at Risk ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Young Adult