Objective To explore the impact of lung-protective mechanical ventilation (low tidal volume and optimal positive end-expiratory pressure (PEEP) on cerebral perfusion pressure (CPP) and cerebral oxygen metabolism.Methods Forty patients with severe cerebral injury along with respiratory failure were randomly assigned into two groups:lung-protective ventilation group A and conventional ventilation group B.Group A was planned to prescribe tidal volume 6 ～ 8 mL/kg,initial FiO240％,PEEP gradually increasing from 2 cmH2O to matched with FiO2 elevation,but the FiO2 was kept at permissive lower level.Group B was formulated with tidal volume 8 ～ 12 mL/kg,PEEP stepwise increasing from 0 2 cmH2O to match with FiO2 elevation,but PEEP was kept at permissive lower pressure.The intracranial pressure (ICP),mean arterial pressure (MAP),CPP,arterial and jugular venous blood gas were monitored.Results PEEP (8.2±3.32 cmH2O),ICP (19.7 ±3.6 mmHg),PaCO2 (54±7.3 mmHg),jugular venous carbon dioxide partial pressure (PjV CO2,56.7 ± 9.6 mmHg) in group A were higher than those (5.7±2.3 cmH2O,16.9±3.8 mmHg,41 ±5.2 mmHg,49.8 ±6.9 mmHg) in group B (P＜ 0.05 or P ＜ 0.01).VT,FiO2 in the group A were lower than those in the group B.There were no differences in PaO2/FiO2,jugular venous oxygen saturation (SjVO2),MAP,and CPP between two groups.PaCO2 were significantly correlated with CPP (r =0.368,P =0.019) while there was no correlation with ICP,PaO2,SjVO2,PjVCO2 (all P ＞0.05).CPP (69.7 ± 12.3 mmHg) was higher in case of PaCO2 (46 ～60mmHg) than those (61.5 ±9.1 mmHg) in case of PaCO2 (35 ～45 mmHg).There was correlation between PEEP and ICP (r =0.436,P =0.005).When PEEP was divided into three groups:≤52 cmH2O,6 ～ 102 cmH2O and ＞ 102 cmH2O,ICPs were different one another among three groups.When PEEP ＞ 102 cmH2O,it had a distinguished negative correlation with CPP (r =-0.395,P =0.017),while PEEP ≤ 102 cmH2O,CPP presented decreasing tendency.SjVO2 correlated with PaO2 (r =0.403,P =0.014) and PjVCO2 (r =-0.502,P =0.001) respectively.There were no significant relationships between SjVO2 and CPP,ICP,MAP,PEEP,respectively.Conclusions Lung-protective mechanical ventilation was relatively safer in patients with severe cerebral injury compared with conventional mechanical ventilation.Mild PaCO2 elevation (46 ～ 60 mmHg) combined with higher PEEP (＜ 102 cmH2O) did not decrease CPP.There was no difference in SjVO2 between the two modes of mechanical ventilation,suggesting no changes in cerebral metabolism occurred.

Capillary bronchitis is a common respiratory infectious disease. In the early childhood,it is mainly caused by respiratory syncytial virus,which is closely related with later asthma. The pathogenesis is still not entirely clear. Recent studies have found that glutathione functions in keeping airway epithelial integrity,a-gainst lung injury and inflammation. This article summarizes the protective effect of glutathione in capillary bron-chitis.

Objective To study effect of immediate abundant sucralfate suspension perfusion to prevent upper gastrointestinal hemorrhage on the organophosphorous insecticides toxicosis suffer after washing stomach.Methods Total 83 patients suffering organophosphorous insecticides toxicosis were divided randomly into 2 groups randomly.In the control group,40 samples were given cimetidine 0.4 g by vein injection after stomach washing completely twice one day. Meanwhile,they were taken sucralfate 1.0 g/(4 times day) orally or by nastal feeding,continuing 5 days.In the treatment group,the samples were perfused sucralfate suspension 3.0 g (grind to powder,mixed with warm water 80 ml) by stomach tube after each stomach washing,and given routine treatment to assist (method as the control group).Results In the aspects of recessive hemorrhage,conspicuous hemorrhage and hospitalizing period the treatment group was significant decreased compared with the control group (P＜0.05).However,Analysis of the results showed no significant difference in death rate (P＞0.05).Conclusion Immediate abundant sucralfate suspension perfusion after washing stomach has significant curative effect on preventing upper gastrointestinal hemorrhage and decreasing hospitalizing period.

Objective To establish a radioresistant human cell line from esophageal squamous car-cinoma cells and detect the marker expression of cancer stem cells (CSCs). Methods A radioresistant hu-man esophageal squamous carcinoma cell line KYSE-150R was established by fractionated irradiation. Mor-phological changes from KYSE-150 to KYSE-150R were observed by phase- contrast microscopy. Karyotype analysis was performed by G-banding. The radiosensitivity of these two cell lines was assessed by colony for-marion assays. The cell cycle distribution was assayed by flow cytometry. CSCs markers of β-catenin and In-tegrin-β_1 were measured by Western Blot. Results The population doubling time of KYSE-150 and KYSE-150R were (23.62±0.23) hrand (25.90±0.55) hr, respectively (t =6.62,P=0.00). The numbers of chromosomes in KYSE-150R cells were increased and chromosome aberrations were observed. The SF_2, D_0, D_q and N values of KYSE-150R were all higher than those of KYSE-150. The ratio of D_0 values was 1.21. After irradiation, the number of S-phase cells of KYSE-150 increased from 45.35%±4.03% to 55.09%± 1.70% (t = -3.86,P=0.02) and G2/M phase cells decreased from 9.91%±3.83% to 1.15%±0.32% (t = 3.95, P = 0.02). However, no apparent change of cell cycle distribution for KYSE- 150R was observed. The expression levels of CSCs markers, β-catenin and Integrin-β_1 in KYSE-150R were about 2 times of those in KYSE-150. Conclusions The new cell line KYSE-150R is more radioresistant than its parental cell line KYSE-150. The CSCs in KYSE-150R is more than those in KYSE-150, which may suggest that CSCs is re-lated with the radioresistance.

OBJECTIVE: To analyze the occupational hazardous factors in hospital pharmacy so as to enhance pharmacist’s awareness of self-protection against such hazards. METHODS: The occupational hazardous factors including physical factors, chemical factors and psychological factors etc were analyzed and the countermeasures were discussed. RESULTS & CONCLUSIONS: Pharmacists should be cautious to the occupational hazards, strengthen traning and education, raise awareness of self-protection to guard against the occupational hazard event.

OBJECTIVE:To provide references for the evaluation of drug suppliers in hospital so as to promote the suppliers to enhance their service level. METHODS: The drug suppliers were evaluated comprehensively with on-time delivery percentage, drug price and post-sale service as evaluation criteria. RESULTS & CONCLUSIONS: The evaluation of drug suppliers can not only raise the service level of the suppliers, but also facilitate a scientific and standardized management of drug supply. However, great importance should be attached to the impartiality and fairness in the evaluation.

Objective To analyze the effect and safety of budesonide combined with psychological intervention on the treatment of the children with bronchitis. Methods 60 children with capillary bronchiolitis in Enze hospital from June 2014 to May 2016 were randomLy divided into the control group and the experimental group, 30 cases in each group. The control group were received conventional treatment, such as, anti-inflammatory, antiviral, bronchodilator and oxygen inhalation. At this basis, the experimental group were given budesonide aerosol inhalation combined with psychological intervention. The clinical therapeutic effect in the two groups were compared. Results The cough stopping time, hospitalization time and the time of lung wheezing rale in the experimental group were significantly shorter than those in the control group, and the adverse reactions in the experimental group were significantly lower than those in the control group, and the difference between the 2 groups was statistically significant(P<0.05). Conclusion The children with capillary bronchiolitis patients were given budesonide inhalation combined with psychological intervention on the basis of routine therapy, which can effectively improve the clinical symptoms, improve the curative effect, low incidence of adverse reactions, shorten the treatment time, which is worthy of clinical application.

This paper reports a woman diagnosed with citrullinemia type I (CTLNⅠ) in puerperium who was unfortunately died later. The 28-year-old patient (G1P1) delivered a live girl at 39 +2 gestational weeks and was transferred from a local hospital to Henan Provincial People's Hospital on January 11, 2020, due to "a 3-day paroxysmal confusion accompanied by dizziness 4 days after delivery". Intermittent confusion, elevated blood ammonia, and citrulline concentration, and encephaledema were presented 10 h after delivery, and the patient eventually died of cerebral hernia on the day of self-discharge. Two pathogenic mutations of the ASS1 gene were found by genetic testing, including c.422t>G (p.val141gl; HET) and c.431c>G (p.pro144arg; HET) and confirmed the diagnosis of CTLNⅠ. CTLNⅠ is a life-threatening disease that could be easily overlooked and misdiagnosed and was difficult to treat. It most often occurs in newborns and infants, whilst it is rare during pregnancy and postpartum. The possibility of this disease should be considered in patients with neurological system symptoms and elevated blood ammonia during pregnancy or puerperium.

Objective To determine the effect of cetuximab(C225)on the radioresistant human esophageal squamous carcinoma eell line KYSE-150R.Methods A radioresistant human esophageal squamous carcinoma cell line KYSE-150R was established by fractionated irradiation.Morphological changes from KYSE-150 to KYSE-150R were observed by phase-contrast microscopy.Karyotype analysis was performed by G-banding.The radiosensitivities were analyzed by colony formation assays.Results The population doubling time of KYSE-150 and KYSE-150R were(23.6±0.2)h and(25.9±0.6)h (t=6.6,P<0.01),respectively.The chromosome number of KYSE-150R was increased and chromosome aberrations were observed from(69.3±1.9)h to(73.7±1.2)h(t=-8.83,P<0.01).The SF2,D0,Dq and N values of KYSE-150R were all higher than those of KYSE-150.After 5μg/ml of C225 added,the SF2,D0,Dq and N values were significantly decreased as compared to the control.After C225 treatment,the G0/G1 and G2/M phase cells were increased,while S-phase cells decreased(t=-4.478-4.308,P<0.05).Conclusion Cetuximab can enhance the radiosensitivity of radioresistant human esophageal squamous carcinoma cell line KYSE-150R.

Objectives To evaluate the association between serum cystatin C and carotid atherosclerosis.Methods Medical data,including physical examinations,serum levels of cystatin C,bilirubin,uric acid and other biochemical markers and duplex ultrasonographic scanning for the carotid artery,of 1741 healthy adults (1193 men and 548 women) who sought physical check-up at Peking Union Medical College Hospital during January 2010 and December 2011 were collected,and those with hypertension,diabetes and liver or renal function failure were excluded.Based on the results of carotid duplex uhrasonography,all the adults checked were assigned to two groups,one with thickened intima-media and atherosclerotic plaque (group A),the other with non-thickened intima-media and non-atherosclerotic plaque (group B).Difference in serum cystatin C,bilirubin,uric acid and other biochemical markers between the two groups was analyzed by using Student's t test.The correlation between the markers and carotid plaque was analyzed by using Spearman correlation analysis.The correlated factors of the carotid thickness and plaque appearance were analyzed by using unconditional Logistic regression analysis.Results Serum level of cystatin C was significantly increased in group A (t =-8.85,P ＜ 0.05).Thickness of carotid intima was positively correlated with serum cystatin C (r =0.21,P ＜ 0.05).In multivariate Logistic regression analysis,high level of serum cystatin C was not an independent risk factor of carotid atherosclerosis.Conclusion Relationship between serum cyatatin C and carotid atherosclerosis was not confirmed in our populations,which should be explored further in cohort studies.