Objective To explore the efficacy of noninvasive positive pressure ventilation technology com-bined with respiratory stimulant in the treatment of pulmonary encephalopathy in patients with COPD.Methods For-ty -eight COPD patients with early pulmonary encephalopathy were included.They were randomly divided into the treatment group and control group.The treatment group was treated by not only regular treatment and noninvasive posi-tive pressure ventilation technology,but also respiratory stimulant.The control group was only treated by regular treat-ment and noninvasive positive pressure ventilation technology.The indexes were recorded,including tracheal intubation rate,clinical recovery rate,mortality,Glasgow coma score,arterial blood gas analysis and adverse reactions.Results Compared with the control group,the arterial blood gas analysis of treatment group on the 2h,24h and 72h were statis-tically significant different(P <0.05).The GCS score on the 24h and 72h were also statistically significant different [24h,(13.4 ±1.6)vs.(11.8 ±2.1),P <0.05;72h,(14.6 ±1.5)vs.(12.4 ±2.4),P <0.05].The treatment group had lower tracheal intubation rate(12% vs.56.5%,P =0.001),shorter consciousness recovery time[(3.0 ± 0.5)h vs.(5.6 ±0.7)h,P =0.023],shorter hospitalization time in ICU[(12.6 ±1.5)d vs.(19.2 ±1.8)d,P =0.004]and better clinical recovery(22 /25 vs.10 /23,P =0.001)than the control group.But the mortality rate had no significant difference between the two groups(1 /25 vs.4 /23,P =0.129).Conclusion NIPPV combined with respiratory stimulant is an effective,safe and simple method for treatment of COPD complicated with pulmonary encephalopathy.It can significantly improve the clinical symptoms and the index of arterial blood gas analysis,and it can shorten consciousness recovery time and decrease tracheal intubation rate.But close observation must be carried out,and the invasive mechanical ventilation should be promptly executed in case of emergency or exacerbation.

To investigate the role of ligustrazine on relaxation of the isolated rabbit corpus cavernosum tissue in vitro, the effects of ligustrazine on the corpus cavernosum were observed by using experimental method of smooth muscle strips. Concentration-responses to phenylephine (PE) and KCl were recorded. The results showed that ligustrazine concentration-dependently depressed the contraction response of smooth muscle strips induced by PE. The maximum percentage relaxation of cavernosal strips by ligustrazine was 74.1% +/- 6.2% (compared with control: 21.9% +/- 5.6%, P < 0.01). Ligustrazine concentration-dependently reduced the amplitude of the contraction induced by cumulative doses of PE or KCl, shifted the cumulative concentration response curves of PE and KCI to the right and depressed their maximal responses. It was concluded that ligustrazine could significantly relax the cavernosal muscle contraction induced by PE in vitro. The results suggested that ligustrazine inhibited calcium ion influx.
Calcium Channels/drug effects ; Muscle Contraction/*drug effects ; Muscle Relaxation/*drug effects ; Muscle, Smooth/*drug effects ; Muscle, Smooth/physiology ; Penis/*drug effects ; Penis/physiology ; Phenylephrine/pharmacology ; Potassium Chloride/pharmacology ; Pyrazines/*pharmacology

Objective To explore the related infection factors of the internal jugular vein indwelling central venous catheter , and make prevention countermeasures according to the infection factors of central venous catheter infections .Methods A total of 564 patients admitted in liver and gallbladder surgical ward with external jugular vein indwelling central venous catheter were se‐lected ,extract the relevant hospital infection data in patients by the XingLin hospital infection real‐time monitoring system ,and SPSS15 .0 statistical analysis was conducted .Results The infection rate of 564 cases of patients was 4 .07% .The rate of gram‐neg‐ative bacteria infection was 43 .5% ,the gram positive bacteria infection accounted for 34 .8% ,fungi accounted for 21 .7% ,including multiple drug‐resistant bacteria infection accounted for 52 .1% .Catheter indwelling 14 d or more infection rate was 8 .5% ,14 d fol‐lowing infection rate was 2 .1% ,and infected patients for more advanced cancer and patients with severe acute pancreatitis .Pipe joint respectively with heparin cap and needle positive pressure infusion joint connections ,infection rate was statistically different (P<0 .05) .Conclusion The infection of internal jugular vein indwelling central venous catheter should not be ignored ,and the oc‐currence of catheter‐related infection of patients is closely related to state of an illness ,the time of catheter insertion ,and the joint device and so on .

OBJECTIVETo investigate whether myocardial bridging (MB) is an independent risk factor for coronary atherosclerosis proximal to the bridge site in the left anterior descending coronary artery (LAD) in diabetic patients.

METHODSFrom March 2011 to December 2012, 9862 patients with suspected coronary disease underwent coronary computed tomography angiography (CCTA) using a dual-source CT scanner. The baseline clinical characteristics (age, gender, smoking history, presence of hypertension, dyslipidemia, diabetes mellitus, family history of heart attack and body mass index) and the results of CCTA were reviewed. Two radiologists evaluated the MB and coronary atherosclerosis stenosis (CAS) over 50% in the LAD and made a diagnosis by consensus. Significant independent risk factors for CAS were investigated by logistic regression analysis.

RESULTSOf the 2345 patients identified to have diabetes mellitus, 1373 had MB, among whom 827 had coronary atherosclerosis proximal to the bridge site; 972 of the diabetic patients were free of MB, among whom 254 had coronary atherosclerosis at the equivalent site. None of the patients had CAS in the tunneled segment. After adjusted for clinical data, logistic regression analysis showed that MB in the LAD was significantly correlated with coronary atherosclerosis in the proximal LAD in diabetic patient (OR=3.91) and non-diabetic patients (OR=2.69) (P<0.05).

CONCLUSIONIn diabetic patients, atherosclerosis occurred frequently in the segment proximal to MB in the LAD, and MB in the mid-LAD is an independent risk factor for CAS in the proximal LAD.

Angiography ; Atherosclerosis ; Coronary Artery Disease ; Coronary Stenosis ; Diabetes Mellitus ; Humans ; Myocardial Bridging ; Myocardium ; pathology ; Risk Factors

To investigate the role of ligustrazine on relaxation of the isolated rabbit corpus cavernosum tissue in vitro, the effects of ligustrazine on the corpus cavernosum were observed by using experimental method of smooth muscle strips. Concentration-responses to phenylephine (PE) and KCl were recorded. The results showed that ligustrazine concentration-dependently depressed the contraction response of smooth muscle strips induced by PE. The maximum percentage relaxation of cavernosal strips by ligustrazine was 74.1% ±6.2 % (compared with control: 21.9 % ±5.6 %, P ＜0.01). Ligustrazine concentration-dependently reduced the amplitude of the contraction induced by cumulative doses of PE or KCl, shifted the cumulative concentration response curves of PE and KCl to the right and depressed their maximal responses. It was concluded that ligustrazine could significantly relax the cavernosal muscle contraction induced by PE in vitro. The results suggested that ligustrazine inhibited calcium ion influx.

Objective To evaluate the efficacy and safety of desonide 0.05％ cream in the treatment of mild to moderate infantile atopic dermatitis (AD).Methods A multicenter,randomized,openlabeled,active-controlled clinical trial was conducted.A total of 120 infants with AD were enrolled from Department of Dermatology,Beijing Children's Hospital,Capital Medical University,Children's Hospital of Chongqing Medical University and Children's Hospital of Fudan University between December 2016 and November 2017.These patients were randomly divided into 2 groups to be topically treated with desonide 0.05％ cream (test group,n =61) and hydrocortisone butyrate 0.1％ cream (control group,n =59),respectively.After the treatment for 1,2 and 3 weeks,the response rate,improvement of eczema area and severity index (EASI) and infants' dermatitis quality of life (IDQOL) were evaluated,and adverse events and reactions were recorded.Statistical analysis was carried out with SAS 9.4 software using confidence interval method and non-inferiority test for the comparison of response rates between the test group and control group,two-sample t test for the comparison of quantitative data between two groups,paired t test for comparing pre-and post-treatment EASI scores and IDQOL scores.If the data were not normally distributed or there was heterogeneity of variance,Wilcoxon rank sum test was used for the comparisons of pre-and posttreatment EASI scores and IDQOL scores before and after the treatment,and chi-square test was used for the comparison of unordered categorical data between the test group and control group.Results At weeks 1,2and 3 after the initial treatment,analysis of the full analysis set (FAS) showed that 46 (86.79％),49(92.45％) and 51 (96.23％) patients in the test group received improvement respectively,and 36 (83.72％),35 (81.40％) and 41 (95.35％) in the control group received improvement respectively.The non-inferiority test showed that the response rate in the test group was non-inferior to that in the control group (non-inferiority boundary value was-0.15).At the baseline,1,2 and 3 weeks,the EASI scores in the test group were 4.57 ± 3.19,0.72 ± 0.89,0.45 ± 0.87 and 0.18 ± 0.40 respectively,and the EASI scores in control group were 4.50 ± 3.29,1.03 ± 1.81,0.62 ± 0.85 and 0.28 ± 0.82 respectively.Paired Wilcoxon rank sum test showed that the EASI scores in the test group and control group significantly decreased after the treatment for 1,2 and 3 weeks compared with those at the baseline (the test group:T =-715.5,-9.4,-715.5,respectively,all P ＜ 0.001;the control group:T =-437.5,-473.0,-472.0,respectively,all P ＜0.001).However,Wilcoxon rank sum test revealed that there was no significant difference in the EASI scores between the two groups at any of the above time points (P ＞ 0.05).Paired Wilcoxon rank sum test showed that IDQOL scores in the test group significantly decreased at the above time points after the treatment compared with those at the baseline (all P ＜ 0.001),while Wilcoxon rank sum test revealed that there was no significant difference in the IDQOL score between the test group and control group (all P ＞0.05).Adverse reactions were observed in 12 (19.7％) patients in the test group,and 10 (16.9％) in the control group,and there was no significant difference in the adverse reactions between the two groups (x2 =0.029,P ＞ 0.05).Conclusion The efficacy of desonide 0.05％ cream in the treatment of mild to moderate infantile AD is equivalent to that of hydrocortisone butyrate 0.1％ cream,so desonide 0.05％ cream can be a treatment option for mild to moderate infantile AD.

Delivery of follistatin (FST) represents a promising strategy for both muscular dystrophies and diabetes, as FST is a robust antagonist of myostatin and activin, which are critical regulators of skeletal muscle and adipose tissues. FST is a multi-domain protein, and deciphering the function of different domains will facilitate novel designs for FST-based therapy. Our study aims to investigate the role of the N-terminal domain (ND) of FST in regulating muscle and fat mass in vivo. Different FST constructs were created and packaged into the adeno-associated viral vector (AAV). Overexpression of wild-type FST in normal mice greatly increased muscle mass while decreasing fat accumulation, whereas overexpression of an N terminus mutant or N terminus-deleted FST had no effect on muscle mass but moderately decreased fat mass. In contrast, FST-I-I containing the complete N terminus and double domain I without domain II and III had no effect on fat but increased skeletal muscle mass. The effects of different constructs on differentiated C2C12 myotubes were consistent with the in vivo finding. We hypothesized that ND was critical for myostatin blockade, mediating the increase in muscle mass, and was less pivotal for activin binding, which accounts for the decrease in the fat tissue. An in vitro TGF-beta1-responsive reporter assay revealed that FST-I-I and N terminus-mutated or -deleted FST showed differential responses to blockade of activin and myostatin. Our study provided direct in vivo evidence for a role of the ND of FST, shedding light on future potential molecular designs for FST-based gene therapy.
Activins ; Animals ; Follistatin* ; Genetic Therapy ; In Vitro Techniques ; Mice ; Muscle Fibers, Skeletal ; Muscle, Skeletal ; Muscular Dystrophies ; Myostatin ; Negotiating

OBJECTIVETo investigate the effects of chuanxiongzine on the relaxation of isolated rabbit corpus cavernosum tissues.

METHODSObservations were made on the relaxing effect of chuanxiongzine on phenylephrine (PE)-precontracted corpus cavernosum and cavernosal strips preincubated with L-NAME, and ODQ, using endothelium removal and experimental method of smooth muscle strips. The effect of chuanxiongzine on cAMP and cGMP levels in corpus cavernosum was measured by 125I radioimmunoassay.

RESULTSChuanxiongzine had concentration-dependent relaxing effect on the cavernosal muscle contraction induced by PE (EC50 1.58 x 10(-4) mol/L). This relaxing effect was partially antagonized by ODQ and not blocked by L-NAME or endothelium removal. In PE-precontracted cavernosal strips, chuanxiongzine induced relaxation accompanied with an increase in cAMP and cGMP levels.

CONCLUSIONChuanxiongzine was effective in relaxing cavernosal muscle precontracted by PE in vitro. And its relaxing effect may be enhanced by increasing cGMP and cAMP levels in the corpus cavernosum.

Animals ; Cyclic AMP ; metabolism ; Cyclic GMP ; metabolism ; Dose-Response Relationship, Drug ; In Vitro Techniques ; Male ; Muscle Relaxation ; drug effects ; Muscle, Smooth ; drug effects ; physiology ; Penis ; drug effects ; physiology ; Pyrazines ; pharmacology ; Rabbits

OBJECTIVE: To discover the relationship of transcriptional levels and promoter methylation status of CHFR gene in human nasopharyngeal carcinoma,to discuss the significance and epigenetic mechanism of CHFR inactivation in NPC, and to evaluate the feasibility of detecting methylated CHFR in nasopharyngeal swab as a means for diagnosis of NPC. METHOD: Transcriptional levels of CHFR was evaluated by RT-PCR. Methylation specific PCR was used to detect the methylation status of CHFR in NPC cells, normal nasopharyngeal epithelia, primary tumors and their paired nasopharyngeal swabs. Detailed methylation status was confirmed by bisulfite sequencing. NPC cells were treated by the methyltransferase inhibitor 5-aza-dC and the reactivation of CHFR was evaluated by RT-PCR. RESULT: CHFR transcription was inactivated in NPC. The methylation frequency in NPC primary tumors and their paired swabs were 65.5% and 63.8%, respectively, with a 86.2% concordance. Bisulfite sequencing revealed a dense methylation in NPC cells and primary tumors, but all the normal nasopharyngeal epithelia were unmethylated. CHFR expression were restored after 5-aza-dC treatment. CONCLUSION CHFR is epigenetically inactivated by promoter methylation in NPC. Detecting methylated CHFR can be served as a useful non-invasive means for diagnosis of NPC.
Aged ; Carcinoma ; Cell Cycle Proteins ; genetics ; DNA Methylation ; Epigenesis, Genetic ; Female ; Gene Silencing ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; genetics ; pathology ; Neoplasm Proteins ; genetics ; Neoplasm Staging ; Poly-ADP-Ribose Binding Proteins ; Promoter Regions, Genetic ; Ubiquitin-Protein Ligases

Objective:To observe the effect of combining scalp acupuncture with feedback training on muscle tone, motor ability, plantar pressure distribution and joint range of motion of stroke survivors with lower limb spastic paralysis.Methods:A total of 212 stroke survivors were randomly divided into a combination group ( n=70), an exercise group ( n=70) and a scalp acupuncture group ( n=72) according to a random number table. All of the patients received routine medication and 120 minutes of rehabilitation training six days a week for 8 consecutive weeks. The rehabilitation training included guidance on good posture, posture change training, balance training and gait training. The scalp acupuncture and exercise groups were additionally provided with 40 minutes of scalp acupuncture and lower limb intelligent feedback training, while the combination group was given both. Muscle tension, balance and lower extremity movement were quantified before and after the training, and a gait evaluation system was used to detect the plantar pressure distribution on the affected side and the range of motion range of the lower limb joints during walking. Results:After the treatment, significant differences were observed in the average modified Ashworth scores, modified Berg scale scores, Fugl-Meyer lower extremity ratings and modified Barthel Index scores compared with before the treatment. The average scores of the combination group were then significantly better than those of the other two groups. The average load bearing ratios of the affected toes, metatarsal bones Ⅰ-V, medial arch, external arch, medial heel and external heel had improved significantly in all of the groups, with the improvement of the combination group again significantly greater than those of the other groups. The same pattern of improvement was observed in the groups′ average pelvic rotation angles, hip flexion angles, knee flexion angles and ankle dorsiflexion angles.Conclusion:Combining scalp acupuncture with intelligent feedback can significantly improve lower extremity functioning after a stroke. That should improve performance in the activities of daily living of stroke survivors.