Objective To observe the clinical efficacy of lung detoxification soup for treatment of patients with ventilator associated pneumonia(VAP)and its effects on serum procalcitonin(PCT),high sensitivity C reactive protein (hs-CRP)and white blood cell count(WBC). Methods A prospective randomized controlled trial was conducted, sixty cases of VAP with traditional Chinese medicine(TCM)syndrome of accumulation of phlegm and heat in lung from Department of Intensive Care Unit(ICU)in the First Affiliated Hospital of Anhui TCM University were enrolled, and the CASIO fx-360P function calculator was applied to generate random numbers to proceed to simple randomized dividing into two groups(each,30 cases). In the control group,mechanical ventilation,anti-infection,prevention of stress ulcer,early enteral nutrition,early weaning of ventilator and conventional western medicine treatment were given to the patients,while in the treatment group,based on the above conventional treatments in the control group,additionally the lung detoxification soup was given(soup composition:radix astragali 20 g ,baical skullcap root 15 g,coptis 10 g,shellfish 8 g,pinelliae tuber 10 g,white mustard seed 10 g,heartleaf houttuynia herb 15 g, honeysuckle flower 15 g,forsythia 15 g,banlangen 15 g,rhubarb 10 g,salvia miltiorrhiza 30 g)by nasal feeding, once 100 mL,twice a day. The therapeutic course was 7 days in both groups. The changes of TCM syndrome integral, levels of serum PCT,hs-CRP and WBC before and after treatment and the clinical efficacy were compared between the two groups. Results After treatment,the TCM syndrome integral,the levels of WBC,serum PCT,hs-CRP were significantly lower than those before treatment in both groups,and the decrease in treatment group being more marked〔TCM syndrome integral:4.73±1.10 vs. 10.33±1.46,WBC(×109/L):8.71±0.55 vs. 10.77±0.65,PCT (μg/L):1.64±0.40 vs. 5.71±1.25,hs-CRP(mg/L):4.96±1.06 vs. 8.85±1.53,all P<0.05〕. The total effective rate of treatment group was significantly higher than that in the control group〔(93.33%(28/30)vs. 73.33(22/30),P<0.05〕. Conclusion The lung detoxification soup can significantly improve the clinical symptoms,reduce the levels of WBC,serum PCT and hs-CRP in patients of VAP with TCM syndrome of accumulation of phlegm and heat in lung, therefore the soup may play a beneficial role as an adjuvant therapy for such patients.

Objective To investigate the effects of Reduqing Oral Liquid (RDQ) on endotoxic fever and plasma nitric oxide (NO) levels of rabbits. Methods Sixty rabbits were randomly divided into 6 group:Acetylsalicy Acid (APC) group, RDQ high dosage group, RDQ low dosage group, RDQ middle dosage group, Shuanghuanglian (SHL) group, model group, ten rabbits of each group. Body temperature and plasma NO of each group were observed. Results In RDQ high dosage group and middle dosage group, plasma NO and fever were reduced significantly (P

Objective To study the effect of psychological counseling for patients with thoracic surgery recovery period.Methods Ono hundred patients with lobectomy were selected,they were divided into experimental group and control group with 50 cases each according to the treatment method.Two groups of patients were in the ward completed indwelling catheter,inserted into the right double lumen endotracheal tube by high seniority anesthesiologists,postoperative given perfect analgesia.Two group patients were treated with routine operation before the visit,assess the condition and signed the anesthesia informed consent,the test group were given psychological support therapy,explain in detail postoperative recovery period may be uncomfortable,eliminate the anxiety of patients,establish the confidence to overcome the disease,Two groups of patients after surgery by the recovery room nurse to give psychological counseling,complete extubation and record the restlessness,24 h after the patient satisfaction questionnaire.Results In test group patients were able to follow instructions and coordinate nurse smooth tube removal,15 cases of patients need to brake,additional sedatives and dehyed extubation,the difference between the two groups has statistical significance (P ＜ 0.05).The satisfaction questionnaire in test group was significantly higher than that in control group:100％ (50/50) vs.82％ (41/50),there was statistical difference (P ＜ 0.05).Conclusion Psychological counseling can effectively avoid agitation in recovery period of patients with postoperative chest tube removal,smooth.

Minimally invasive treatment with lung volume reduction is the promising future for severe pulmonary emphysema patients. With emerging and improving of new techniques and instruments, it would become an important choice for managing severe emphysema. A comprehensive review is here documented through the corvelative techniques, instruments, new achievements and latest research work.(J Intervent Radiol, 2006,15:53-56)

The NF-kappaB pathway regulates the expression of over 150 target genes, e.g., cytokines, chemokines, leukocyte adhesion molecules and inducible effector enzymes. Consequently, it plays a crucial role in innate and adaptive immune responses, inflammatory response, stress responses, apoptosis and so on. IkappaB kinase (IKK) is the key of this pathway, and it owns a special structure which consists of catalytic subunit and regulatory subunit. Naturally, the activation of IKK needs the interaction of the two subunits and phosphorylation by its upstream kinases. Actually, there are two methods of activation of the NF-kappaB pathway, and both of the methods need the IKK complex. Given to the crucial role of IKK, researchers have isolated and synthesized amounts of IKK inhibitors, and these provide a great convenience to develop novel anti-inflammatory and anti-tumor drugs.

Objective To observe the effect of early non-invasive positive pressure ventilation(NIPPV)on the treatment of serious hypoxemia induced by acute left heart failure. Methods Forty patients with acute left heart failure( Grade Ⅳ heart function)were randomly divided into two groups. Patients in both groups accepted supportive treatment included cardiotonics, diuretics, vasodilators, in additional to these high concentrations of oxygen were given in conventional group, and non-invasive positive pressure ventilation were given in NIPPV group by biphasic positive airway pressure(BiPAP). Systolic blood pressure, heart rate, respiratory rate, blood-gas analysis( pH, PaO2, PaCO2, SaO2 )and clinical signs were observed at 2 hours after treatments. Results Compared to control,RR( [ 19.55 ± 1.88] vs [21.85 ±3.51 ] ) BPM] ,HR ( [96.40 ±2.80] vs[ 103.20 ±6.78 ] BPM), SBP ( [ 116.30 ± 8.95 ] mm Hg vs [ 122.50 ± 6.13 ] mm Hg), pH (7.404 ± 0.027 vs 7.358 ±0.05) ,SaO2 ( [93.57 ± 1.18]% vs [91.97 ± 1.85]% ) ,PaO2 ( [75.58 ±4.61 ]mm Hg vs [68.38 ±7.95]mm Hg), PaCO2 ( [ 38.69 ± 3.06 ] mm Hg vs [ 43.61 ± 2.65 ] mmHg) were significantly different in NIPPV group( t = 2.582,4.146,2.558,3.534,3.256,3.505,5.428, Ps ＜ 0.05 ). We found no significant differences in the comparisons before treatments. Hypoxia improved in NIPPV group,and the total effective rate was 95% in NIPPV group and 70% in control group,which showed significant difference( x2 =4.329 ,P ＜0.05 ) Conclusion BiPAP non-invasive positive pressure ventilation combined with routine treatment in treating heart failure, could promptly correct hypoxia, improve heart function and shortening disease course.

Objective To investigate the regulation of metabolize characteristic of some antibiotics in ACST in human bile, and provide the theoretic basis for physician selecting antibiotic rationally when biliary tract has been infected. Methods Samples of ACST in human bile were obtained by ERCP + ENBD, contents of Cefradine, Cefoperazone, Ceftriaxone, Ciprofloxacin and Lomefloxacin in human bile were simultaneously measured by HPLC method. Results After antibiotics were given through iv 0. 25 ～ 1. 5 hour, an increase was observed in contents of all antibiotics in bile, and the changes of Ceftriaxone and Ciprofloxa-cin were the most significant ( P <0.01). Ceftriaxone and Ciprofloxacin had a higher Cmax than other antibiotics, and Cefoperazone had a longer tl/2. Conclusion As maintaining a little time to tmax , a higher Cmax and a longer tl/2 in the bile by iv, Cefradine and Ciprofloxacin are recommended in the patient with ACST.

Objective A new Continous-monitoring. Methods Determinating adenosine desaminase was established,and its experiment conditions including pH,substract concentration et al,and methodological performance were investigated.In this study,Two reagents were used,reagent one including 6 mmol/L α-ketoglutarate acid,0.35 mmol/L NADH,0.8 mmol/L ADP,0.1 mmol/L EDTA-Na2,1000U/L glutaic dehydrogenase.Reagent two including 12 mmol/L adenosine.Results The linearity range of this method can reach 97 U/L,the variance within batch and between batch were 4.9% and 6.53% respectively.Correlation analysis showed there was significant correlation between ours and Berthelot′s method.Conclusion The continous-monitoring method is accurate,simple and easy to be used in clinic.

OBJECTIVE A practical gene chip which aimed to detect and identify pathogens rapidly and exactly is developed on the basis of patent technology of nano-enlargement-detection. METHODS Oligonucleotide probes for the specific gene fragments of target pathogens were designed and immobilized on gene chip.Target sequences were labeled by nanogold as reporter materials.After hybridization,its results were recorded by the interaction between nanogold and silver which amplified the hybridization signal to form brown particles,which could be detected by naked eyes. RESULTS The probes designed were all of strong specificity and great reliability possessing identity of hybridization conditions.The reaction time for marking could be decreased by properly raising the ratio of nanogold and nucleic acid and the speed of labeling reaction could be fastened significantly by gentle agitation.A better hybridization results could be obtained when the samples were hybridized for 8 hours at 45℃ with 0.8 mol/L ionic strength,and then strictly rinsed.Furthermore,the hybridization efficiency could be increased remarkably by slight circumgyratation.A better chromatic effect resulted from the reaction way in 3min?3 at 37℃.The sensitivity of gene chip assays in this test could reach to 100 fmol/L.Compared with traditional detection approach,detection by the chip displayed such advantages as speediness and simplicity and the detection results could be easily recognized by naked eyes. CONCLUSIONS The chip detection technology has met the demand of design exhibiting high sensitivity,strong specificity,and easy operation without special device and showing a promising prospect.

Objective For realizing the simultaneous detection of multiple pathogens,by looking for a method with a combination of the new gene chip detection system based on nano-gold with the technology of restriction endonuclease without PCR.Methods Helicobacter pylori,Mycoplasma pneumoniae,Chlamydia trachomatis,Candida albicans,Ureaplasma urealyticum,and EB virus were selected as the experimental targets.Endonuclease Hha Ⅰ was selected as tool enzyme.After bering digested by Hha Ⅰ,the digested fragments of samples were tailed with poly-A.The samples were then detected by the gene chip detection system based on nano-gold.Both specific and common probes were used in the hybridization.The coincidence rate of the detection results between the new constructed chip test and the fluorescence quantitative PCR test in 168 clinical samples was examined.The stability and sensitivity of chips detection were also checked.Results The new constructed nano-gold-baesd gene chip combined with restrictive enzyme digestion without PCR could be used to detect the target pathogens.The coincidence rate of the chip detection test and fluorescence quantitative PCR test in 168 clinical samples was 89.2%.Chip detection results showed that the stability of chips detection was 100% and the sensitivity was 50pmol/L.Conclusion The newly constructed nano-gold-baesd gene chip combined with restrictive enzyme digestion without PCR can be widely applied in the simultaneous detection of Mycoplasma,Chlamydia,fungus,virus and bacteria.It shows a bright prospect in increasing the throughput of identifieation of pathogene.