Objective To evaluate the effects and side effects of three different recruitment maneuvers (RM) in acute respiratory distress syndrome (ARDS) caused by extrapulmonary disease.Methods Forty-four patients of extrapulmonary ARDS, according to crossover design methods, were undergone three RM in different periods, including sustained inflation (SI), increase progressively positive end expiratory pressure (IP), pressure control ventilation (PCV). Heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP), oxygenation index, lung compliance were recorded before and after RM, and were analyzed for statistical analysis. Results Oxygenation index and lung compliance were increased obviously in a short time after RM, improvement of IP method were better more obviously than the other two methods [1 h oxygenation index after RM:227 ± 42 vs 190 ± 19,186 ± 21; lung compliance:(59.4±12.5 ) ml/cm H2O(1 cm H2O = 0.098 kPa) vs (50.1 ± 9.3 ), (49.7 ± 10.6) ml/cm H2O;P＜ 0.05], 2h after RM,there were no statistical difference among the three methods (P＞0.05). After RM,HR and CVPwere increased, MAP was decreased in a short time, changes of SI method were smaller than the other two inethods [10 min HR after RM: (94.0±10.3 ) beats/min vs (116.0 ± 14.8 ), ( 107.0 ± 5.7 ) beats/min; CVP:(13.7±3.1 )cm H2O vs ( 18.4 ± 6.7 ), ( 15.4 ± 2.7 )cm H2O; MAP: ( 87.0 ± 12.1 ) mm Hg( 1 mm Hg = 0.133 kPa) vs (73.0 ± 4.8), (81.0 ± 6.6) mm Hg;P＜ 0.05), 20 min after RM, there were no statistical difference among the three methods (P＞ 0.05). Conclusion When extrapulmonary ARDS undergo RM ,IP method is the most effective on increasing oxygenation index and lung compliance, SI method has the smallest side effect on hemodynamics.

This device is composed of dissolving bucket,magnetic pump,four-passage valve,heater, stirrer,filter,speed-changing equipment,dividedfilling controller and etc.It can be used for preparing and filling various liquid medicament,such as oral or external-use solution,colloid,emulsion and suspension. The proposed device is highly automatic and efficient.Time and labour saving,simple and safe.Moreover, its performance is reliable and stable,and the working capacity is large.

Objective To analysis and determine the possibility of the Citellus undulatus infected with Yersinia pestis surviving the winter in an experimental study, and to provide scientific experimental basis for the study on the mechanism of Yersinia pestis preservation. Method In 2006,09 to 2007,04 and 2007,09 to 2008,04 in Xinjiang Wusu-Gurtu natural foci of plague, under natural conditions, the over the winter process of Citellus undulatus carrying the plague bacteria was simulated, and 178 Citellus undulatus were infected with Yersinia pestis (1×107 Bacteria/mouse) using artificial injection method. One hundred seventy-eight Citellus undulatus infected with Yersinia pestis were kept into a construction of the black (1-5 ℃) basement (2 meters under the ground) in the plague focus. In doing so, these Citellus undulatuses almost simultaneously stepped into hibernation. After waking up from hibernation in following year in April, the survived mice carrying the plague bacteria were observed. Results Sixty-eight mice survived among the 178 infected with Yersinia pestis after 6 months of hibernation (through October to the following year in April), and the remaining 110 were all dead without pulling through the hibernation period. The survival rate was 38.2% (68/178). The organ culture of Yersinia pestis of the 110 dead mice(Citellus undnlatus) were tested, 67 were negative(-), 43 positive(+), with a positive rate of 39.1%(43/110). Among the rats with positive plague bacteria, the congestive pulmonary edema and the pathological changes of the hemorrhagic inflammation of the heart, liver, spleen, kidney and injection site could be seen clearly; the plague-free mice were not found to have any pathological changes. The survived 68 mice over the winter were autopsied and observed after being fed up for 20 days. No any pathological changes were found among these mice, and culturing of Yersinia pestis of the heart, liver, spleen, lungs and the tissue of injection site of these mice were all negative (-). Conclusions Citellus undulatus can carry Yersinia pestis during hibernation, but some fail to carry the bacteria through the entire process of hibernation persistently. Yersinia pestis was negative in the survived mice at the end of hibernation. The results showed that Citellus undulatus can not carry Yersinia pestis over the winter.

Objective To explore expression of hypoxia inducible factor-1?(HIF-1?)in kidney cells during hypoxia/reoxygenation injury,and to study the effect of Danshen on prevention of the hypoxia/reoxygenation injury to cells.Methods Human renal proximal tubular cells(HK-2)were used as the target cell.There were 3 groups:control group,model group,Danshen group.hypoxia/reoxygenation models after neonatal asphyxia were established with liquid paraffin covering method.Expression of HIF-1? were detected with strcp avidin biotin complex(SABC)immunohistochemistry at following different time points:hypoxia 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia;and hypoxia/reoxygenation 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia/reoxygenation.Results HIF-1? was expressed mainly in HK-2's nucleus.There had low expression of HIF-1? in HK-2 cells under the normal culture,and its expression level kept rising quickly during hypoxic/reoxygenatic culture,until 4 h after the beginning of reoxygenation.Compared with the study group,the expression level of HIF-1? in HK-2 cells of the Danshen group were significantly lower at different time points(Pa

Nine compounds were isolated from the leaves of Ilex latifolia. Their structures were respectively identified as 5-hydroxy-6, 7, 8, 4'-tetramethoxyflavone (1), tangeretin (2), nobiletin (3), 5-hydroxy-6, 7, 8, 3', 4'-pentamethoxyflavone (4), 5, 6, 7, 8, 4'-pentamethoxyflavonol (5), 5, 6, 7, 8, 3', 4'-hexamethoxy-flavonol (6), 5-hydroxy-3', 4', 7-trimethoxyflavanone (7), soyacerebroside I (8), and soyacerebroside II (9) by their physicochemical properties and spectroscopic data Compounds 1-9 were isolated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Ilex ; chemistry ; Plant Leaves ; chemistry

Currently, the randomized controlled trial (RCT) becomes the generally accepted golden standard for clinical trials. It can be classified into two types based on different design, that is, the explanatory randomized controlled trial (ERCT) and the pragmatic randomized controlled trial (PRCT). In designing a clinical trial, researcher may select either of them according to the goal of research. The design feature of PRCT and its application in designing clinical trials of acupuncture were introduced in this paper. Further attention should be paid on resolvent of how to apply PRCT in combining with other design methods organically to work out clinical trial scheme with high quality and consistent with the characteristics of acupuncture as possible, for evaluating the effect of acupuncture more accurately and objectively, so as to promote the international application and development of acupuncture therapy.
Acupuncture Therapy ; methods ; Biomedical Research ; Humans ; Randomized Controlled Trials as Topic ; methods

Objective To investigate the impact of adding folic acid,vitamin B12 and probucol to standard antihypertensive medication on plasma homocysteine (Hcy) and asymmetric dimethylarginine (ADMA),serum NO and eNOS of essential hypertensive patients.Method A total of 120 patients with hypertension were randomly divided to three groups (n =40 each):group 1 (standard medication),group 2 (adding folic acid 5 mg/day and vitamin B12 500 μg twice daily) and group 3 (adding folic acid 5 mg/day and vitamin B12 500 μg twice daily and probucol 500 mg twice daily).Plasma Hcy and ADMA,serum NO and eNOS levels were observed at baseline,2 and 12 weeks after various therapy.Results In group 1,concentrations of plasma Hcy [(23.06 ± 14.15) μmol/L,(23.67 ± 12.31) μmol/L,(23.25 ± 11.64)μmol/L],ADMA[(0.21 ± 0.12) μmol/L,(0.23 ± 0.13) μmol/L,(0.21 ± 0.09) μmol/L] and serum NO [(64.14 ± 15.07) μmol/L,(65.29 ± 15.04) μmol/L,(65.32 ± 13.58) μmol/L],eNOS[(20.02 ±4.50) μg/L,(20.79 ± 4.03) μg/L,(19.82 ± 5.70) μg/L] remained unchanged during the 12 weeks therapy (all P ＞0.05).In group 2,concentrations of plasma Hcy [(12.54 ±6.49) μmol/L] and ADMA [(0.18 ± 0.07)μmol/L] were significantly decresed after the treatment of 12 weeks than the treatment baseline value [(21.51 ± 7.82) μmol/L,(0.20 ± 0.12) μmol/L] and 2 weeks value[(19.38 ± 8.14)μmol/L,(0.21 ± 0.12) μmol/L],however the concentrations of serum NO and eNOS showed contrary results of the Hcy and ADMA's.(all P ＜0.05).In group 3,similar changes occurred at 2 weeks after therapy (P ＜0.05 2 weeks vs.baseline and 12 weeks vs.2 weeks).Plasma ADMA level was positively correlated with Hcy at baseline (r =0.546,P ＜ 0.05).Conclusions Supplementation of folic acid,VitB12 and/or probucol helps to improve endothelial function and reduce plasma Hcy and ADMA levels in patients with hypertension.

Objective To investigate the clinical efficacy of Qiangli Pipa Syrup for the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to observe its effects on pulmonary function and interleukin 6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)levels in the patients.Methods Eighty patients with AECOPD of phlegm-heat obstructing the lung syndrome were randomly divided into the observation group and the control group,with 40 patients in each group.Patients in the control group were treated with conventional western medicine,and patients in the observation group were treated with Qiangli Pipa Syrup on the basis of treatment for the control group.Both groups were treated for 5 days.The two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores(including cough,expectoration,shortness of breath,and wheezing),pulmonary function parameters[the forced expiratory volume in one second(FEV1)and the ratio of FEV1 to the forced vital capacity(FVC)(FEV1/FVC)],blood gas indicators[arterial partial pressure of oxygen(PaO2),blood oxygen saturation(SaO2)and arterial partial pressure of carbon dioxide(PaCO2)]and the levels of the inflammatory factors of IL-6,CRP,and PCT before and after treatment.Moreover,the clinical efficacy and safety of the patients in the two groups were evaluated.Results(1)After 5 days of treatment,the total effective rate of the observation group was 95.00%(38/40),and that of the control group was 77.50%(31/40).The intergroup comparison(tested by chi-square test)showed that the therapeutic effect of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores of cough,expectoration,shortness of breath,and wheezing in the two groups were reduced compared with those before treatment(P＜0.05),and the reduction in the observation group was significantly superior to that in the control group(P＜0.05).(3)After treatment,the pulmonary function parameters of FEV1/FVC and FEV1 in the two groups were improved compared with those before treatment(P＜0.05),and the improvement in the observation group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the blood gas indicators of PaO2 and SaO2 levels in the two groups were increased compared with those before treatment(P＜0.05),and the PaCO2 level was decreased compared with that before treatment(P＜0.05).The increase of PaO2 and SaO2 levels and the decrease of PaCO2 level in the observation group were significantly superior to those in the control group(P＜0.05).(5)After treatment,the serum levels of inflammatory factors of IL-6,CRP,and PCT in the two groups were lower than those before treatment(P＜0.05),and the reduction in the observation group was significantly superior to that in the control group(P＜0.05).(6)The incidence of adverse reactions in the observation group was 10.00%(4/40),while that in the control group was 7.50%(3/40).There was no significant difference between the two groups(P＞0.05).Conclusion Qiangli Pipa Syrup exerts certain effect in treating patients with AECOPD of phlegm-heat obstructing the lung syndrome,which can effectively relieve the clinical symptoms,improve the pulmonary function and blood gas indicators,and inhibit inflammatory response of the patients,with high safety profile.

Objective To investigate the characteristics and diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT in patients with secondary malignant peripheral nerve lesions. Methods 18F-FDG PET/CT studies of 8 cases of secondary malignant peripheral nerve lesions confirmed by histopathology or follow-up were analyzed retrospectively. The maximum standardized uptake value ( SUVmax ) of infiltrating peripheral nerves and contralateral normal peripheral nerves was measured and compared with their morphological appearances on CT. Paired student t-test was performed by SPSS 10.0. Results Twelve secondary malignant peripheral nerve lesions with high 18F-FDG metabolism were found in 8 cases. On PET imaging,the lesions distributed along the neurovascular tissues or intervertebral foramina with appearances resembling those of fibre bundles,radices or nodes on PET but no density differences with the surrounding soft tissue or fat planes on CT. The SUVmax was 6.86 ± 3.87. The contralateral normal peripheral nerves showed no abnormal 18F-FDG uptake with a SUVmax of 1.10 ±0.46,which was significantly different from that of the secondary malignant peripheral nerve lesions (t = 9.231,P ＜ 0.001 ). Conclusion 18 F-FDG PET/CT may be useful in locating the secondary malignant peripheral nerve lesions and in assessing its regional infiltration.

Objective To observe the clinical efficacy of Tiao Shen Jie Jing needling (regulating the mind and release spasm) in treating post-stroke upper-limb spastic palsy. Method Ninety patients with post-stroke upper-limb spastic palsy were randomized into an observation group and a control group, 45 cases each. The observation group was intervened by Tiao Shen Jie Jing needling, while the control group was given ordinary acupuncture. The Modified Ashworth Scale (MAS), short-form Fugl-Meyer Assessment (SFMA) and Barthel Index (BI) were evaluated and recorded prior to the treatment, after 2-week and 4-week treatment and 3 months later after the intervention; the serumγ-aminobutyric acid (GABA) was detected before and after the treatment. Result The total effective rate was 83.3% in the observation group versus 61.0% in the control group, and the efficacy of the observation group was superior to that of the control group (P<0.05). The scores of each scale showed improvements after the treatment in both groups (P<0.05), and the improvements in the observation group were more significant (P < 0.05). The follow-up showed continuing improvements in the scales in the observation group, which were superior to those in the control group (P<0.05); after the treatment, the content of GABA in the observation group was significantly higher than that in the control group (P<0.05). Conclusion Tiao Shen Jie Jing needling can effectively ameliorate the upper-limb spasm,as well as the motor function of the upper extremities, improve the activities of daily living and maintain a long-term efficacy, better than ordinary acupuncture. The action mechanism is related to the regulation of GABA content in serum.