Objective On the basis of the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), to establish and appraise a new prognostic evaluation system for elder patients with respiratory failure undergoing mechanical ventilation in order to predict hospital mortality in the respiratory intensive care unit. Methods Two hundred and thirty-eight senile patients with respiratory failure having had mechanical ventilation during their hospitalization were retrospectively analyzed. Patients were randomly divided into 2 groups: model group (n=138) and validation group (n=100). Data of model group were analyzed by monofactorial and multifactorial regression analysis to screen the risk factors. Risk factors were given numerical values according to different grades, and complementary scoring system was then established. APACHE Ⅱ system was combined with complementary scoring system with Logistic multiple regression to form SRFMV system, a special evaluation system for the senile patients with respiratory failure undergoing mechanical ventilation. One hundred patients from validation group were evaluated by both SRFMV system and APACHE Ⅱ system, and the results were then compared to assess the validity and reliability of SRFMV system. Oxygenation index, positive end expiratory pressure (PEEP), tidal volume, phlegm quantity and character, and pulmonary auscultation were selected to serve as standard for complementary scoring system. Mortality equation was set up with logistic multiple regression analysis. Results The predication sensitivity and specificity evaluated by SRFMV system in validation group (0.878 and 0.821, respectively) outstripped that evaluated by APACHE Ⅱsystem (0.818 and 0.771, respectively); the area under ROC curve in SRFMV system and the X2 value in Lemesshow-Hosmer statistic (0.911 and 13.77, respectively) also outstripped that in APACHE Ⅱsystem (0.860 and 11.808, respectively). Conclusions SRFMV system is of better sensitivity and specificity, in which the prediction of mortality is closely consistent with the reality. SRFMV system can be applied to obtain valid predictions of relevant outcomes in senile patients with respiratory failure underwent mechanical ventilation.

10% was found in 5 patients (16%). Mesothelial hyperplasia was found to be significantly higher in patients with PTE than that in the control group (P

Objective To explore the strategies of prevention and treatment of MRSA infection in ICU patients. Methods The clinical data of 6 patients with MRSA infection occurring at the same time in ICU were reviewed retrospectively. Results Vancomycin was given in 4 cases, 250mg twice daily, and teicoplanin was given in one case, 400mg once daily. MRSA cultures were negative in 5 cases after antibiotic treatment. Conclusions MRSA infection occurs frequently in ICU patients, and it spreads readily. Antibiotic treatment, isolation and bacteriological monitoring are very important measures for control of MRSA infection in ICU patients. [HS(1*2/3]

Objective In the present study we examined the roles of three proinflammatory cytokines, i.e. tumor necrosis factor-?(TNF-?), interleukin 1?(IL-1?), and IL-8 in the early phase of APTE, and analyze the impact of these cytokines on the systemic circulation. Methods APTE was induced in 7 anesthetized dogs by injecting the thrombus of own blood into the right jugular vein. Seven animals receiving only warm sterile saline served as controls. Arterial serum samples were collected regularly (0h, 0.5h, 1h, 2h, 4h, 6h) and cytokine levels could be measured by radio-immunity assay. Results Introduction of clots into the pulmonary circulation caused significant increase in the mean pulmonary arterial pressure(from 99.1?5.7 to 66.8?15.3mmHg, P

BACKGROUND:Studies have shown that chitosan and other natural polysaccharides have heparin-like anticoagulant function after sulfonated modification. Sulfonated chitosan has good anticoagulant property because the sulfonate group formed by sulfonated chitosan is similar with the active group of heparin. OBJECTIVE: To prepare the anticoagulant chitosan nanoparticles and to detect its morphology, physical and chemical properties and biological security. METHODS: Chitosan nanoparticles were synthesized by emulsion-chemical cross link. Sulfonated chitosan nanoparticles were synthesized by sulfonation reaction. Its morphology was described by transmission electron microscope. The peak-value change of its specific groups was observed by infrared spectroscopy. (1) Coagulation experiment: Heparin, chitosan nanoparticles and 10, 30 and 50 mg of sulfonated chitosan nanoparticles were added into the blood of Spraque-Dawley rats. The coagulation indicators were detected. (2) Hemolysis experiment: deionized water, physiological saline and 10, 30, 50 g/L sulfonated chitosan nanoparticles extracts were added into 2% red blood cel suspension of rabbits. The hemolysis rate was detected. (3) Cytotoxicity experiments: DMEM medium containing fetal bovine serum and 10, 30, 50 g/L sulfonated chitosan nanoparticle extracts were used to culture human umbilical vein endothelial cels. Cel relative growth rate and toxicity grading were detected after 72 hours. RESULTS AND CONCLUSION: Scanning electron microscopy showed that sulfonated chitosan nanoparticles had good morphology, with a diameter of 50 nm. Infrared spectroscopy showed that the sulfonated replacement occurred.In vitro coagulation experiments showed that sulfonated chitosan nanoparticles had significant anticoagulant effects in a dose-dependent manner. Sulfonated chitosan nanoparticles meet the national safety standard for hemolysis rate of less than 5%, non-induced hemolysis property. Cytotoxicity assays showed that sulfonated chitosan nanoparticles extracts had no significant cytotoxicity, and its biological safety was in line with the national standards.

Objective To determine the clinical characteristics of hospitalized patients who died of pulmonary thromboembolism (PTE) confirmed by autopsy. Methods The medical and autopsy records of 36 cases of autopsy proven fatal PTE in General Hospital of PLA from 1982 to 2001were reviewed. Cases of tumor embolism, fat embolism, and amniotic fluid embolism were excluded from the study. Results Six patients [16 7% (95% confidence interval, 6 4% to 32 8%)] were diagnosed as PTE prior to death. The diagnosis of PTE was significantly lower in patients with COPD or coronary artery disease. No risk factors were noted in only 4 patients (13 9%). Only a minority of patients had pleuritic pain or hemoptysis(8 3% and 11 1% respectively), while a significantly larger proportion of patients (25%, P

Objective To establish a simple ,low cost and stable method to detect right ventricular pressure in mice .Methods A PE-50 duct length 15 cm(outside diameter :0 .9 mm ,inner diameter :0 .5 mm) was bent on one terminal and the other terminal was inserted into a 7# syringe needle to connect to a pressure transducer .This duct was intubated into right ventricle via right external jugular vein to detect right ventricular pressure in 80 SPF grade male C57BL/6 mice .Successful cases and operation time were re-corded .Besides ,40 SPF grade male C57BL/6 mice were randomized into the control group (n=20) and chronic hyperbaric hypoxia group(n= 20) .Mice in chronic hyperbaric group were raised in a hyperbaric chamber of simulated 5 000 m high altitude for 4 weeks .The control group was raised outside the chamber simultaneously .Right ventricular systolic pressure was detected with the PE duct .Left and right ventricles were detached and weighed ,and Hermann-Willson index was calculated .Results With this PE duct ,right ventricular intubation success rate was 90% (72/80) ,the operation cost approximately 3 to 5 min each mouse from the separation of blood vessels to detect the time needed for the right ventricle waveform .right ventricular systolic pressure[(39 .52 ± 4 .34 )mm Hg] and Hermann-Willson index(0 .356 ± 0 .039)of chronic hyperbaric hypoxia group were significantly higher than that of control group [(21 .24 ± 2 .7)mm Hg and (0 .256 ± 0 .020)] ,which has significant positive correlation (P<0 .01) .Conclusion It is simple ,fast ,stable ,costing low and of high success ratio to detect right ventricular pressure with this method .

Objective: To investigate the effect of diabetes on the intensity of sarcoplasmic reticulum Ca2+-ATPase (SERCA2a)-SUMOylation and SERCA2a activity of myocardium in experimental rats.
Methods: The 8 weeks old SD rats were divided into 2 groups, Diabetic group, with diet-induced type 2 diabetic rats and Control group, with normal rats. The systolic and diastolic cardiac functions were evaluated by echocardiography and left ventricular pressure measurement. The intensity of SERCA2a-SUMOylation was examined by co-immunoprecipitation and SUMOylation kit.
Results: Compared with Control group, Diabetic group had decreased systolic and diastolic cardiac functions, especially for diastolic function;decreased SERCA2a protein expression and intensity of SUMOylation;decreased SUMOylation E2 (Ubc9 ) protein expression. The protein levels of SUMO1, SAE1 and SAE2 were similar between 2 groups.
Conclusion: The intensity of SERCA2a-SUMOylation and Ubc9 decreased in diabetic myocardium which implies that SERCA2a-SUMOylation and Ubc9 were closely related to the damage of diabetic myocardium in experimental rats.

BACKGROUNDThe methylation of tumor suppressor genes is believed to be one of the most important mechanisms of oncogenesis. In order to research the malignant transformed mechanism induced by radiation, the abnormal promoter methylation of p14(ARF) , p16(INK4a) and BUB3 genes are detected in the transformed human bronchial epithelial cells (BEP2D) induced by α-particles.

METHODSAbnormal promoter methylations were detected with methylation specific PCR (MSP). The level of p14 ARF gene transcription was analyzed by using RT-PCR. DNA was purified and transformed and sequenced.

RESULTSp14(ARF) gene was not methylated in BEP2D cells, but was methylated in the malignant transformed BERP35T-1 cells, and the level of its transcription was depressed remarkably in the latter. However p16(INK4a) gene, which shares two exons with p14 (ARF) gene, was not methylated. BUB3 gene was not methylated in BEP2D as well as BERP35T-1 cells and this was further proved by sequencing analysis.

CONCLUSIONSThe methylation of two tumor suppressor genes (p14(ARF) and p16(INK4a)) that share two exons and controll cell cycle are not synchronous in the transformed human bronchial epithelial cells induced by α-particles, and the methylated one (p14(ARF)) is repressed in transcription. The gene of mitosis spindle check-point (BUB3) is unmethylated.

Objective To discuss the experience of medical care for the assurance of security of the'Shenzhou Ⅶ'astronauts at the landing venue in order to innovate a high efficient mobile ICU in medical helicopters.Method The data collected from over.as and domestics were reviewed and analyzed to find out the possible causes of accidental injuries to astronauts during acmspaec flight,and to pmpose a practicably and effectively prophylactic strategy and reasonable treatments for the astronauts with accidental injuries.Results Three,high efficient mobile ICU innovated could elqsure the safety ofthe astronauts.The ICUs with high efficiency were set up in the helicopters where the surgery Call he peormed for controlling the danlage.Fine armature made our work mole effective.Conclusions Practicably and effectively Plephylactic measurements and reasonable treatments are the essential aspect of the successfulness for the security of astronauts of manned aemspacecraft flights.The innovated medical care system in helicopters could realized the obligation of swift response and the duty offirst-md.