Objective To observe the clinical effect of Guizhi decoction combined with reduced glutathione in the treatment of pulmonary heart failure patients with acute liver injury.Methods 72 patients with pulmonary heart failure and acute liver injury were divided into treatment group and control group.Patients in the control group were given conventional treatment for pulmonary heart disease,patients in the treatment group were treated with Guizhi decotion and reduced glutathione for three weeks.After three weeks,the clinical efficacy and clinical indicators were evaluated.Results In the treatment group,clinical symptoms,signs,liver function improvement,and oxidized antioxidant indicators,the difference were statistically different compared with those in the control group (t =10.25,5.45,3.23,17.34,11.49,11.61,all P ＜0.05).The total effective rate of the treatment group was 88.9％,which was significantly higher than thant of the control group 52.8％ (x2 =11.36,P ＜ 0.05).After treatment,the plasma lipid peroxide (LPO),superoxide dismutase(SOD) had statistically significant differences between the two groups (t =53.08,-9.03,all P ＜ 0.05).Conclusion Guizhi decoction combined with the reductive glutathione can improve symptoms of pulmonary heart failure patients with liver dysfunction,and have good clinical efficacy.

Objective Observe the synergy nerve protective effect and its mechanism of Sodium Ferulate (SF) and Ginseng saponins Rg1.Methods Ischemia-reperfusion injury models of rats were copied.The effects of SF,Ginsengsaponins Rg1 and the combination on infarction volume,lectin markers positive cells,peroxidase proliferation of activated receptorγ(PPAR-γ) mRNA expression,SOD activity and MDA content were observed.Results The blank control group didn't show infarction areas under TTC staining,and the cerebral infarction volume percentage of model control group,sodium ferulate group,ginsenoside Rg1 group and combination group was 44.2％,25.0％,20.4％,6.2％ respectively.The lectin positive cells number of blank control group,model control group,sodium ferulate group,ginsenoside Rg1 group and combination group were 11.4,44.6,27.8,23.0,13.4/500μm2 respectively; the PPAR-γmRNA expression were1883,1022,1473,1537,1843 respectively; the MDA content was 1.52,3.50,2.62,2.38,1.66 mmol/mg respectively; and the SOD acitivity was 71.54、73.14、81.72、82.22、91.10 U/mg respectively.Compared with model control group,sodium ferulate group,ginsenoside Rg1 group and combination group reduced the volume of cerebral infarcts (P＜0.01),inhibited the microglia activation(P＜0.01),increased the p PPAR-γ mRNA expression(P＜0.01),decreased the MDA content(P＜0.01) and increased SOD activity(P＜0.05,P＜0.01)significantly,and the effect of combination group was better than either sodium ferulate group or ginsenoside Rg1 group(P＜0.05,P＜0.01).Conclusion SF and Ginseng saponins Rg1 had collaborative neural protection and its activation on PPAR-γ may be one of the mechanisms.

OBJECTIVE To approach the effect of empirically applying ?-lactam antibiotics for treatment of hospital-acquired pneumonia on distribution and antibiotic-resistance of pathogenic bacteria.METHODS To investigate 141 patients with hospital-acqired pneumonia in intensive care unit during Jan 2001-Oct 2005,and divide into 3 groups:third generation cephalosporin group;lactamase inhibitor group;and other lactam antibiotics group according to different initial antibacterial strategy,then analyze difference in distribution and antibiotic-resistance of pathogens among each group.RESULTS We acquired 164 strains of pathogens.Comparing with other two groups,the proportion of Gram-positive cocci in lactamase inhibitor group was higher significantly(P

OBJECTIVE To sum up the distribution and drug-resistance of pathogens in hospital-acquired pneumonia(HAP) at each stage,and then to offer references for treatments of HAP.METHODS To retrospectively analyze 46 patients whose course was over 30 day and who were in hospital from Jan 2000 to Oct 2005,and to divide course into prophase,metaphase and anaphase,and then to clinically study the drug-resistance and distribution of pathogens in each phase.RESULTS In prophase the most pathogens were Gram-negative bacilli(accounted for 87.5%),in metaphase the Gram-positive cocci were manifold distinctly;and in metaphase and anaphase drug-resistance of Gram-negative bacilli increased distinctly;and the fungi were not detected in prophase,but were positive in metaphase and anaphase.CONCLUSIONS In prophase application of third generation cephalosporin which is more sensitive to Gram-negative bacilli as an empirical antibacterial therapy is right;based on the drug-resistance and distribution of pathogens,the antibacterial drugs and treatment must be readjusted.

Objective To investigate the effect of postoperative analgesia by using loxoprofen sodium on dental implant patients at different time points. Methods A total of 400 patients with dental implant treatment were divided into two groups by random number table method. The experimental group was firstly given loxoprofen sodium tablets (60 mg) in 30 minutes preoperatively, and the control group was firstly given on three hours after surgery (60 mg). Local anesthesia was used to all dental implant surgery. Using the Wong-Baker Smile Assessment method in operation and Numerical Rating Scale (NRS) in postoperative respectively to assess pain level in surgery and 3 h, 6 h, 12 h and 24 h after surgery. Results The percentages of painless patients of the experimental group and the control group in operation were 99%(198/200) and 97%(194/200), and there was no significant difference between them (χ2=2.041, P>0.05); the percentages of painless patients of the experimental group at 3 h, 6 h, 12 h after surgery were 60.5%(121/200), 79.0%(158/200), 83.5%(167/200), and the control group were 47.0%(94/200), 64.5%(129/200), 71.5%(143/200), and there was significant difference between the control group and the experimental group (χ2=14.255,15.447, 11.165, P=0.007, 0.004, 0.011); however, in the two groups, there was no significant difference at 24 h after surgery, the experimental group was 93.0% (186/200), the control group was 89.5% (179/200) (χ2=2.468, P>0.05). Conclusions Preoperative administration with loxoprofen sodium tablets can significantly reduce the risk of postoperative pain, and could be used as a conventional implant surgery analgesic program.

Aim To investigate the effect of astragalus injection on the expression of JNK3(c-jun N terminal kinase)protein and JNK3 mRNA interrelated by apoptosis after hypoxia/hypoglycemia and reoxygenation in hippocampal neurons of rats.Methods The hippocampal neurons cultured for eight days were divided into four groups:normal control group,hypoxia/hypoglycemia and reoxygenation group,astragalus injection group and astragalus solution group.Hypoxia/hypoglycemia and reoxygenation group,astragalus injection group and astragalus solution group were treated with hypoglycemia and reoxygenation after being deprived of oxygen and glucose for 30 minutes.Methods of Western blot,ELISA and RT-PCR were used respectively to measure the expression of JNK3 mRNA after hypoxia/hypoglycemia and reoxygenation 0,0.5,2,6,24,72,120 h.Results Compared with normal control group,the mean optic density(MOD)of expression of JNK3 protein and activation of JNK3 protein in hippocampal neurons of rats every time points increased obviously in hypoxia/hypoglycemia and reoxygenation group except 120 h(P<0.05);compared with hypoxia/ hypoglycemia and reoxygenation group,MOD of expression of JNK3 mRNA and activation of JNK3 protein in hippocampal neurons of rats every time points decreased obviously except 120 h in astragalus injection group (P<0.05);compared with hypoxia/hypoglycemia and reoxygenation group,there was no difference in astragalus solution group.Compared with normal control group,MOD of expression of JNK3 mRNA in hippocampal neurons of rats every time points increased obviously in hypoxia/hypoglycemia and reoxygenation group(P<0.05);compared with hypoxia/ hypoglycemia and reoxygenation group,MOD of expression of JNK3 mRNA in hippocampal neurons of rats every time points decreased obviously in astragalus injection group except 120 h(P<0.05);compared with hypoxia/hypoglycemia and reoxygenation group,there was no difference in astragalus solution group.Conclusion Astragalus injection can inhibit the expression of JNK3 mRNA after hypoxia/hypoglycemia and reoxygenation,moreover,it can inhibit the expression of JNK3 protein and decrease the activation of JNK3 protein,accordingly it inhibits hippocampal neuronal apoptosis.

Objective To detect the expression of interleukin (IL)-18 of the peripheral blood cells and IL-18 receptor α chain(IL-18Rα) on the surface of CD_3~+ cells in patients newly diagnosed as immune thrombocytopenia (ITP) before medication and to explore the roles of IL-18 and IL-18Rα in the development of ITP. Methods Eighteen out-patients or inpatients with acute ITP accepting treatment in Qilu Hospital were enrolled in this study and 15 matching healthy subjects were taken as control. Plasma IL-18 level was detected with enzyme linked immunosorbent assay (ELISA), the expression of IL-18Rα on CD_3~+ lymphocytes and total lymphoeytes were measured with flow cytometry; T-bet and GATA-3 mRNA were measured with reverse transcriptase polymcrase chain reaction (RT-PCR). Results The expression of IL-18 in acute ITP plasma was (468. 57 ± 141.62) ng/L and IL-18Rα on the surface of CD_3~+ cells and lymphocytes were (8.50 ±3. 16)% and (9. 16±2.98)% respectively. The levels of IL-18 and IL-18Rα were increased in active ITP patients as compared with those in the controls (P <0. 05). The levels of IL-18 mRNA (0. 12 ±0. 02) and T-bet mRNA (0. 07 ±0. 02) were significantly increased in patients with active ITP as compared with those in the controls (P <0.05), while GATA-3 mRNA (0.0039±0.0014) were significantly decreased in patients with active ITP (P < 0. 05). The balance between T-bet and GATA-3 was significantly disturbed in ITP. Conclusions Through the variation of the levels of gene and protein, our study showed that IL-18 and IL-18Rα might upregulate the expression of Th1-cytokines in ITP patients. It is also suggested that IL-18 has potential association with the development of ITP. Especially, it may provide a new treatment method for ITP by regulating the ratio of T-bet and GATA-3 and resuming the balance of Th1/ Th2.

Objective: To evaluate the efficacy and safety of intravascular ultrasound guidance drug-coated balloon (DCB) in percutaneous coronary intervention (PCI) of situ coronary artery lesions in patients with acute coronary syndrome (ACS), and its effect on thrombus precursor protein (TpP). Methods: Seventy-eight patients with ACS in Central Hospital of Changchun City from January 2015 to January 2019 were selected, including 46 cases with unstable angina pectoris and 32 cases with acute non-ST-segment elevation myocardial infarction. The patients were divided into DCB group (38 cases) and drug-eluting stent (DES) group (40 cases) by random digits table method. Intravascular ultrasound was used to guide PCI in both groups, and DCB and DES were used respectively. Coronary angiography was performed immediately and 6 months after PCI in both groups. Minimum lumen diameter (MLD) was measured by QCA system, and the lumen loss (LLL) was calculated at 6 months after PCI. Plasma TpP before PCI, 1 and 6 months after PCI was measured by enzyme-linked immunosorbent assay (ELISA). Major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction and target lesion revascularization (TLR) were followed up 1, 3, 6 and 12 months after PCI. Results: Immediately after PCI, there was no statistical difference in MLD between DCB group and DES group: (1.87 ± 0.23) mm vs. (2.16 ± 0.15) mm, P>0.05; 6 months after PCI, the LLL in DCB group was significantly smaller than that in DES group: (0.31 ± 0.28) mm vs. (0.48 ± 0.19) mm, and there was statistical difference (P<0.05). There were no significant differences in the incidences of myocardial infarction, TLR and cardiac death in DCB group (P>0.05). Before PCI and 6 months after PCI, there was no statistical difference in TpP between 2 groups (P>0.05); 1 month after PCI, the TpP in DCB group was significantly lower than that in DES group: (15.31 ± 6.13) mg/L vs. (19.46 ± 8.24) mg/L, and there was statistical difference (P<0.05). Conclusions DCB is an accurate and effective treatment for ACS patients with situ coronary artery disease under the intravascular ultrasound guidance, and it can reduce the risk of thrombosis.

Objective: To evaluate the effect of intracoronary injection of recombinant human urokinase on plasma P-selectin in AMI patients with no-reflow during acute PCI. Methods: Ninety-two patients with acute ST-segment elevation myocardial infarction or acute non-ST-segment elevation myocardial infarction admitted to Center Hospital of Changchun City in January 2017 and December 2018 were randomly divided into two groups: 47 patients with intracoronary injection of sodium nitroprusside as control group and 45 patients with intracoronary injection of recombinant human urokinase as treatment group. Among them, 58 were males and 36 were females. The onset time was less than 12 h. The basic data, serum P-selectin, myocardial perfusion index and major adverse cardiovascular events were compared between the two groups. Results: In the treatment group, the corrected TIMI frame number, instant TIMI grade 3 blood flow, myocardial chromogenic grade 3 blood flow, myocardial necrosis marker CTnI, serum P-selectin were significantly lower than those in the control group: 31.26 ± 4.58 vs. 35.15 ± 6.25, 71.1%(32/45) vs. 51.1%(24/47), 64.4%(29/45) vs. 55.3%(26/47), (28.46 ± 3.95) ng/ml vs. (30.18 ± 3.47) ng/ml, (13.26 ± 4.58) ng/ml vs. (15.04 ± 3.98) ng/ml, and EF function was better. In the control group. The incidence of major adverse cardiac events in the treatment group was lower than that in the control group within one month after operation, but there was no statistical significance. Conclusions There is no reflux in patients with AMI during PCI. Intracoronary injection of recombinant human urokinase can improve myocardial perfusion without reflux and has no effect on fibrinolytic system in vivo. It does not increase the risk of systemic hemorrhage and the incidence of serious adverse cardiovascular events.