Objective To investigate the effect of ulinastatin in adjuvant treatment of ventilator-associated pneumonia(VAP)and preliminary clinical efficacy of the therapy mechanism.Methods 76 patients with ventilator-associated pneumonia from January 2015 to February 2016 in Qingyuan People's Hospital of Zhejiang Province were selected and randomly divided into control group and observation group,38 cases in each group.Two groups were given mechanical ventilation,phlegm,anti infection,rehydration,nutritional support and other conventional treatment,the observation group on the basis of routine treatment for ulinastatin adjuvant therapy,comparison of two groups of treatment,the simultaneous determination of serum interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)and tumor necrosis factor alpha(TNF-alpha)levels were measured before and after treatment.Results The total efficiency of the observation group was 94.74％,significantly higher than the control group 78.95％,the difference was statistically significant(P<0.05),the two groups after treatment of serum CRP and PCT levels were decreased significantly compared with before treatment,the observation group after treatment,serum CRP and PCT levels were(45.19+5.79)mg/L and(1.08+0.36)μg/L was significantly lower than that before treatment and control group after treatment,the difference was statistically significant(P<0.05),the two groups after treatment of serum IL-6 and TNF-α levels were decreased significantly compared with before treatment,the observation group after treatment,serum IL-6 and TNF-α levels were(165.29+19.23)pm/mL and(1.16+0.25)pm/mL,was significantly lower than that before treatment and control group after treatment,the difference was statistically significant(P<0.05).Conclusion The inflammatory reaction in patients with ventilator-associated pneumonia ulinastatin can effectively reduce auxiliary patients,reduce inflammatory factors on lung injury,can alleviate the disease progression and to improve its prognosis.

Objective To investigate the changes of hematoma and perihematomal edema in spontaneous hypertensive rats (SHRs),as well as the correlation between blood pressures and perihematomal edemaMethods A total of 24 6-month-old male SHRs were included.They were randomly divided into intracerebral hemorrhage 1-,3-,5-,and 7-day groups (n =6 in each group).Blood pressure was determined by tail-cuff sphygmomanometry.Collagenase Ⅳ was injected into caudate nucleus in order to induce a model of intracerebral hemorrhage.Magnetic resonance T2 weighted imaging was used to observe hematoma and perihematomal edema.Results On day 1 after modeling,the blood pressure was decreased significantly compared to that before modeling,and it was elevated gradually on day 3.Parallel profile test showed that the overall profile was parallel between the change rate of blood pressure and the change rate of perihematomal edema volume (F =2.820,P =0.063).The coincident profile test showed that both the overall profiles did not coincide (F =10.961,P =0.000).The change rate of systolic blood pressure was significantly positively correlated with the change rate of perihematomal edema volume (r =0.527,P =0.024) and the change rate of perihematomal edema volume (r =0.755,P =0.000) showed a significant positive correlation.Conclusions Brain edema appeared and expanded rapidly on the day of intracerebral hemorrhage in SHRs.It reached the peak on day 3,and then dissipated gradually.The blood pressure decreased significantly on day 1 after intracerebral hemorrhage,and it began to increase from day 3 till day 7.The changing trends of the blood pressure and perihematomal edema volume were parallel to each other,and the change rate of systolic blood pressure and the change rate of perihematomal edema volume showed a positive correlation.

Objective:To explore the effect of extracorporeal shock wave combined with meloxicam tablets on joint function and serum matrix metalloproteinase-9 (MMP-9) and resistin levels in elderly patients with osteoarthritis.Methods:80 cases of elderly patients with osteoarthritis in Nanchong Central Hospital from May 2016 to March 2019 were selected as the research objects, and they were randomly divided into two groups, 40 cases in each group. The control group was given conventional oral medicine (meloxicam + potassium glucosamine sulfate tablets), and the observation group was given meloxicam tablets combined with extracorporeal shock wave therapy. The total effective rate, incidence of adverse reactions, and the scores of osteoarthritis symptoms (WOMCA), joint function (Lysholm), serum MMP-9 and resistin before and after 8 weeks' treatment were compared between the two groups.Results:After treatment, the WOMCA score of the observation group was lower than that of the control group, and Lysholm score was higher than that of the control group ( P<0.05); the total effective rate of the observation group (95.00%) was higher than of the control group (77.50%) ( P<0.05); the serum resistin and MMP-9 levels of the observation group were lower than those of the control group after treatment ( P<0.05); there was no significant difference in the incidence of adverse reactions between the observation group (15.00%) and the control group (17.50%) ( P>0.05). Conclusions:Extracorporeal shock wave combined with meloxicam tablets in the treatment of elderly patients with osteoarthritis can significantly improve the clinical symptoms, promote the recovery of joint function, reduce the levels of serum resistin and MMP-9, and further improve the treatment effect with high safety.

AIM: To explore the significance of platelet activation, fibrinolytic activity and the changes of vasoactive mediators in acute myocardial infarction in rabbits and the intervention of amiodarone and metoprolol. METHODS: Fifty New Zealand white rabbits were randomly assigned to five groups, ten for each. Group Ⅰ: sham group, group Ⅱ: acute myocardial infarction(AMI) group, group Ⅲ: AMI and lidocaine group, group Ⅳ: AMI and amiodarone group, group Ⅴ: AMI and metoprolol group.The middle point of left ventricular coronary artery was ligated (groupⅡ,Ⅲ, Ⅳ and Ⅴ ) or a sham ligation(group Ⅰ). Four hours later, blood was collected for measuring plasma concentration of TXB 2, 6-Keto-PGF 1?, ET, NO, plasma activity of t-Pa and PAI.After that, the heart was taken out to evaluate the infarction size(IS). RESULTS: Plasma concentration of TXB 2, ET, NO and plasma activity of PAI were significantly higher in groupⅡ,Ⅲ, Ⅳ and Ⅴ than those in group Ⅰ(P0.05).Compared to group Ⅱ, plasma concentration of ET, NO and PAI activity were significantly decresed (P

Objective To investigate the antimicrobial resistance and distribution of klebsiella pneu‐moniae in Shandong Provincial Hospital and to provide a reference for clinical treatment. Methods The specimens collected in our hospital from January 1,2015 to December 31,2017 were cultured. The drug sensi‐tivity test was carried out according to the unified scheme by paper diffusion method or automated instrument method. The results were interpreted according to the CLSI 2014 M100‐S24,and the data were analyzed by using WHONET5. 6 software. Results From 2015 to 2017,a total of 79 615 specimens were sent to the hos‐pital for bacterial culture,and 2 159 strains of klebsiella pneumoniae (non‐repeat bacteria) were isolated,with a separation rate of 9. 87%, 9. 23% and 9. 98%, respectively. The detection rates of extended spectrum β‐lactamase(ESBLs)‐producing klebsiella pneumoniae strains were 37. 97%,43. 57% and 40. 87% respec‐tively. The specimens were mainly separated from sputum,blood,urine,skin soft tissue,ascites and cerebro‐spinal fluid. Except for the slight decrease in ESBLs‐producing rate of klebsiella pneumoniae in sputum cul‐ture specimens in 2017,other specimens showed an increasing trend year by year,especially in blood culture specimens. The ESBLs production rate of klebsiella pneumoniae increased from 24. 53% in 2015 to 55. 00%in 2017. The drug resistance rate of ESBLs‐producing strains to various antibacterial drugs was significantly higher than that of non‐ESBLs producing strains. ESBLs‐producing klebsiella pneumoniae had a high drug re‐sistance rate to most antibiotics,and it was most sensitive to carbapenems,with drug resistance rates lower than 17%. However,the rate of carbapenem‐resistant showed a rapid rise. Conclusion Klebsiella pneumoni‐ae is a common pathogenic bacteria in clinical practice, and the drug resistance rate of ESBLs producing strains is high. Strengthening the monitoring of bacterial resistance and infection control measures are very important for the effective treatment of bacterial infection.

This study was aimed to examine the expression of apoptosis-associated gene Fas in HeLa cell, explore the effects of the co-immobilized cytokines (tumor necrosis factor-alpha and interferon-gamma), and probe the potential mechanism of action. The preparation and application of the research couple IFN-gamma and TNF-alpha to the polystyrene cell culture plate were performed using the Photo-immobilization method, with different doses (20 ng/well and 200 ng/well) and synthesized optical active material. HeLa cells were treated with cytokines for two dose and 1, 3, 6 days. The result showed that the free cytokines induced HeLa apoptosis quickly, yet the HeLa apoptosis induced by co-immobilized cytokines had longer effect.
Apoptosis ; drug effects ; genetics ; Drug Synergism ; HeLa Cells ; Humans ; Immobilized Proteins ; chemistry ; pharmacology ; Interferon-gamma ; chemistry ; pharmacology ; Tumor Necrosis Factor-alpha ; chemistry ; pharmacology ; Up-Regulation ; fas Receptor ; metabolism

Objective To observe the oral part of the facial artery and facial vein and to provide anatomical data for clinical applica-tion. Methods The origin, branches, course, diameter, position of oral part of facial artery and facial vein were observed on 32 fixed cada-ves (64 sides). Results The position relation between the facial artery and facial vein is non-constant. Measure the distance from inferior border of mandible to corner of the mouth, angulus mandibulae, mental protuberance midpoint. It is (5. 49 ± 0. 63) cm, (2. 50 ± 0. 89) cm and (6. 20 ± 1. 68) cm in the left side respectively, and (5. 69 ± 0. 72) cm, (2. 56 ± 1. 08) cm and (6. 85 ± 1. 86) cm in the right side re-spectively. The diameter of facial artery in inferior border of mandible is (0. 33 ± 0. 08) cm in the left side and (0. 38 ± 0. 07) cm in the right side;while the diameter of facial vein is (0. 40 ± 0. 12) cm in the left side and (0. 42 ± 0. 18) cm in the right side. The facial artery and facial vein are not concomitant and they are not asymmetry also. The position of superior labial artery arteries is constant, but the position of inferior labial artery arteries have more variations. Conclusion The branches, course, diameter and position of oral part of facial artery and facial vein have a number of variations. The superior labial artery arteries could be positioned more easily than inferior labial artery arter-ies. Being familiar with their distribution is of great importance for clinical application.