Objective To set up bronchodilation curve in patients with chronic obstructive pulmonary disease(COPD)or asthma and investigate the features of large and small airways dilation.Methods Pulmonary functions of 44 COPD and 68 asthma patients were determined before and after inhaling Formoterol.Results The curves of FEV1 and FVC rose at 15 minutes after inhaling Formoterol and then declined at 120 minutes post-formoterol in patients with COPD.The curves of FEV1/FVC and FEF75 presented as a wave form,and the curves of FEF50 and FEF75/25 rose at 30 minutes and declined after 30 minutes.The fitting quadr-curves model equations for FEV1,FVC and FEF50 over time were statistically significant(P

Objective To explore the expression of neuronal nitric oxide synthase (nNOS) in the hippocampus in vascular dementia rats.Methods 60 rats were randomly divided into five groups: control group, model 12 h group,model 1 d group, model 3 d group and model 7 d group.An animal model of vascular dementia (VD) was established through repeated cerebral ischemia-reperfusion in rats with repeated bilateral common carotid arteries occlusion. The number of neurons in CA 1 area of hippocampus in every group was observed using HE staining. The expression of nNOS in the hippocampus in VD rats was detected by immunohistochemical staining and western blot method.Results The number of neurons in CA 1 area of hippocampus decreased significantly in 12 h, 1 d, 3 d and 7 d group. The expression of nNOS in CA 1 area of hippocampus was weak in control group and up-regulated in 12 h group and increased further in 1 d group. However, its expression decreased gradually in 3 d and 7 d group.Conclusion nNOS may be related to the injury of hippocampus at early phase in VD rats. It might be regarded as one of mechanisms to cause VD.

Objective To investigate the effect of hypertonic sodium chloride hydroxyethyl 40 injection (HSH)on craniocerebral injury accompanied with hypovolemic shock and ICP.Method Sixty patients suffering from craniecerebral injury accompanied with the hypovolemic shock and admitted to ICU and Neurosurgical Department of Guang dong General Hospital from September 2007 to June 2008,were chosen into the study prospectively.Those who was younger than 18years or older than 70 years,and those who were pregnant or meustruous women,or serious hepatic and renal insufficiency,hypertension,coronaxy artery disease,diabets mellitue,uncontrolled bleeding,brain death,erc were excluded.The patients were randomly divided into 3 groups.Each group included 20 patients and they were resuscitated with LR(500 ml),HIS(4 ml/kg)and HSH(4 ml/kg)respectively.The changos of blood pressure,laboratory examination indices and ICP Were detected before and at 30,60,120 minutes after resuscitation.Results MAP raised over 60 mmHg and ICP declined 10%within 30 min in HIS and HSH groups.The effect of HSH on the improving of blood pressure and the reduction of ICP wag more obvious than that of LR and HIS at 120 minutes(F=18.43,8.99,P<0.05)after resuscitation.There were no obvious oboes of the laboratory examination indices after resuscitation.Conclusions The themputic effect of HSH on ICP and MAP in craniocerebral injury accompanied with hypovolemic shock is obvious and lasting,which would be beneficial to the protection of cerebral function.

Objective To analyze the risk factors of pulmonary embolism in patients with negative Ddimer in serum in order to determine the need of pulmonary computed tomography angiograph (CTA) to confirm the final diagnosis in those patients for avoidance of misdiagnosis.Methods A retrospective analysis of 106 patients suspected to suffer from pulmonary embolism (PE) with serum negative D-dimer checked with pulmonary CTA was carried out.According to the results of CTA, the patients were divided into two groups, namely PE group (n =41) and non-PE group (n =65).The difference in clinic presentation, the time elapsed from onset to visit, N-terminal pro-brain natriuretic peptide (NT-proBNP), high risk factors (such as immobilization for 3 weeks, leg swelling and pain to palpation, history of deep vein thrombosis, malignancy) and Wells score (≥ 4 points indicates probability of PE).And logistic regression analysis was made to investigate the risk factors in PE with negative D-dimer.Results The analysis study showed that 38.6％ of total patients suspected to suffer from PE with serum negative D-dimer were checked by CTA to confirm the presence of PE.One important characteristics of the D-dimer negative PE patients was the longer time consumed from onset to visit [(9.51 ±2.01) d vs.(4.01 ±1.92) d, P＜ 0.05], and majority of the CTA positive patients suspected to suffer from PE with negative D-dimer had high risks of PE (P ＜0.01).Compared with the non-PE group, the Wells score ≥4 points and the level of serum NT-proBNP significantly increased in the PE group (P ＜ 0.01).Logistic regression analysis revealed that dyspnea, high NT-proBNP level and Wells sore ≥ 4 points were risk factors for D-dimer negative PE.Conclusion Delayed treatment was the main cause of misdiagnosis of D-dimer negative PE.Dyspnea, high NT-proBNP level and Wells sore ≥4 points were risk factors for suspected PE patients with negative D-dimer, and these patients should be confirmed by pulmonary CTA.On the contrary, PE could be excluded if patients with D-dimer negative had no these risk factors.

Objective To determine the effect of high dose albumin on permeability of blood brain barrier (BBB) in brain of rats after ischemic-reperfusion (IR) in order to explore its possible mechanism.Methods Establishment of brain ischemic reperfusion rat model by using middle cerebral artery occlusion (MCAO).Medicine treatment was given by caudal vein injection after 2 hours of MCAO.Thirty-six healthy male SD rats were then randomly (random number) divided into 6 groups (n =6 in each):6 h and 24 h sham-operation groups (Group Sham:operation without ischemia),6 h and 24 h normal saline groups (Group NS:NS injection 5 ml/kg) and 6 h and 24 h albumin group (Group Alb:25 ％ Alb injection 1.25 g/kg).Six hours and 24 hours after the end of reperfusion,rats were measured by Zea-Longa score (neural function deficit) separately.Serum concentration of S100B was examined by the ELISA kit and Evans blue in brain tissue was detected by spectrophotometer.The level of AQP4 was examined by Western blot and immunohistochemistry.All data were analyzed by one-way analysis of variance (ANOVA),The intergroup comparisons were analyzed by the least-significant-difference (LSD) test by using SPSS version 17.0 software.Differences were considered statistically significant if P ＜ 0.05.Results Zea-Longa score significantly increased in both group NS and group Alb at 6 h and 24 h (P =0.000).However,there was no significant difference in ZEA-LONGA score of 6 h and 24 h between group Alb and group NS (P =1.000).The serum concentration of S100B in group NS 6 h was significantly lower than that in group Alb at 6h (196.67±20.11 vs 160.04±14.00,P=0.000),and at24h (2.45±0.07 vs.2.23±0.07,P=0.000).Furthermore,concentration of Evans blue in brain tissue in group Alb was significantly higher than that in group NS at both 6 h (0.97 ± 0.08 vs.0.74 ± 0.06,P =0.000) and 24 h (2.45 ± 0.07 vs.2.23 ± 0.07,P =0.000).The expression of AQP4 in brain tissue was higher in group Alb than that in group NS at both 6 h (0.72 ±.0.11 vs.0.57 ± 0.06,P ＜ 0.01) and 24 h (0.80 ± 0.03 vs 0.61 ± 0.02,P ＜0.01).Conclusions High dose albumin contribute slightly in improvement of neural deficit in rats after IR.On the contrary,it can also aggravate the IR injury,which increases brain edema then increase the permeability of BBB.The mechanism may be associated with over-expression of AQP4 in brain tissue.

0.05),APACHEⅡ score,and mortality were higher than those in negative group(P

Objective To investigate effects and its mechanisms of hypertonic saline hydroxyethyl starch 200/0.5 solution on intracranial pressure and brain water content in rats with ischemic cerebral edema.Methods All experiments were conducted in the animal experimental center of Sun Yat-sen University.The 28 male Sprague-Dawle (SD) rats were randomly (random number) divided into hypertonic saline hydroxyethyl starch group,hydroxyethyl starch group,control group and sham operation group,each n =7.Ischemic cerebral edema model was reproduced by middle cerebral artery occlusion (MCAO),followed by reperfusion after ischemia for 2 hours (If the moldel was not successful,other rats were operated to fill the missing models).Then reperfusion after ischemia 2 hours and received hypertonic saline hydroxyethyl starch and hydroxyethyl starch via tail vein at the beginning of reperfusion.The colloidal osmotic pressure (COP) and intracranial pressure (ICP) were evaluated on 0,2,6,12,18,24 hours after the surgery.The water content of the right hemisphere was measured on 24 h after the surgery.Results The ICP of hypertonic saline hydroxyethyl starch group,hydroxyethyl starch group and control group were significantly higher than that of sham operation group on 2,6,12,18,24 h after the surgery.The ICP of hypertonic saline hydroxyethyl starch group was significantly lower than those of hydroxyethyl starch group and control group on 2,6,12,18 and 24 h.But there was no significant difference in ICP of the hydroxyethyl starch group compared with that of control group at all time points.The COP of hypertonic saline hydroxyethyl starch group and hydroxyethyl starch group were significantly higher than the control group and sham operation group at each time point; There was no significant difference in COP (mmHg) of the hydroxyethyl starch group compared with that of hypertonic saline hydroxyethyl starch group at all time points.The brain water content (BWC) of hypertonic saline hydroxyethyl starch group,hydroxyethyl starch group and control group were significantly higher than that of sham operation group on 24 hours after the surgery [(81.24±0.36)％,(83.04±0.10)％,(83.14±0.41)％ vs.(78.37±0.37)％,all P=0.000],BWC of hypertonic saline hydroxyethyl starch group lower than these of hydroxyethyl starch group [(81.24±0.36)％ vs.(83.04 ±0.10) ％,P =0.000] and control group [(81.24 ±0.36)％ vs.(83.14 ±0.41) ％,P =0.000].There was no significant difference in BWC of the hydroxyethyl starch group compared with that of control group [(83.04 ± 0.10) ％ vs.(83.14 ± 0.41) ％,P =0.578].Conclusion Hypertonic saline hydroxyethyl starch solution could significantly ameliorate ischemic cerebral edema and reduce ICP,but the relationship between its elevated COP and reduced ICP has not been confirmed.

[ ABSTRACT] AIM:To explore whether IL-1βinhibits the oligodendrocyte precursor cell ( OPCs) differentiation and affects axonal myelination.METHODS:One-day-old SD rats were randomly divided into control group and LPS group ( 48 rats in each group) .The rats in LPS group were intraperitoneally injected with 1 mg/kg LPS.The rats in control group were injected with an equal volume of PBS.The rats in each group were further divided into 3 h, 24 h, 3 d, 7 d, 14 d and 28 d subgroups after injection.The expression of IL-1βand IL-1R1 in the rat corpus callosum at 3 h, 24 h, 3 d, 7 d was determined by double immunofluorescence and Western blotting.The myelin basic protein( MBP) expression in the rat cor-pus callosum at 14 d, 28 d after injection was also measured.In vitro, primary OPCs culture was performed and divided in-to control group, 30 μg/L IL-1βgroup, 30 μg/L IL-1β+IL-1Ra group and 30 μg/L IL-1Ra group.The expression of MBP in the OPCs induced differentiation for 3 d was observed by double immunofluorescence and Western blotting.RE-SULTS:The expression of IL-1βand IL-1R1 in the rat corpus callosum at 3 h, 24 h, 3 d, 7 d after LPS injection was ob-viously increased and the expression of MBP in the rat corpus callosum at 14 d, 28 d in LPS group was obviously decreased compared with control group in vivo.The level of MBP was significantly decreased after IL-1βtreatment for 3 d in vitro. However, IL-1Ra (IL-1R inhibitor) reversed the down-regulation of MBP expression.IL-1βinhibited the expression of p-ERK, ERK over-expression reversed the down-regulation of MBP expression compared with IL-1βgroup.CONCLUSION:IL-1βinhibits the differentiation of OPCs, which may be involved in ERK pathways, thus leading to axonal hypomyelination in the corpus callosum of septic neonatal rats.

ObjectiveTo investigate the clinical characteristics and pathogenic microorganisms in culture-positive sepsis, to identify its risk factors, and evaluate the prognosis on polymicrobial infection in intensive care unit (ICU).Methods A descriptive retrospective study was conducted. Clinical data of patients aged≥ 18 years, diagnosed as culture-positive sepsis, and admitted to six ICUs of Guangdong General Hospital from October 12th, 2012 to December 1st, 2014 were enrolled. Based on the number of isolated pathogens, patients were divided into polymicrobial infection group (≥two pathogens) and monomicrobial infection group (one pathogen) to investigate the clinical characteristics of patients with culture-positive sepsis and the causative pathogens. Multiple logistic regression was conducted to identify the risk factors for polymicrobial infection. Kaplan-Meier curve was plotted to analyze a 90-day survival rate from the onset of positive blood culture.Results 299 patients with positive blood culture were enrolled. A total of 450 strains of pathogens were isolated including 246 gram-positive cocci (54.67%), 167 gram-negative bacilli (37.11%) and 37 fungi (8.22%). Ninety-one patients had polymicrobial infection, and 208 with monomicrobial infection. Compared with monomicrobial infection group, patients suffering from polymicrobial infection had more advanced age (years: 73.19±18.02 vs. 60.83±18.06,t = -5.447,P = 0.000), also with higher incidence of cerebrovascular diseases [39.56% (36/91) vs. 17.79% (37/208),χ2 = 16.261,P = 0.000] or chronic renal insufficiency [15.38% (14/91) vs. 7.21% (15/208),χ2 = 4.828,P = 0.028], higher incidence of recent hospital stay (≥2 days) within 90 days [73.63% (67/91) vs. 61.54% (128/208),χ2 = 4.078,P = 0.043], longer mechanical ventilation duration [days: 4 (0, 17) vs. 1 (0, 6),U = 7 673.000,P = 0.006], longer length of hospital stay before blood was drawn for culture [days: 21 (7, 40) vs. 9 (3, 17),U = 6 441.500,P = 0.006], and higher incidence of pre-admission intravenous use of antibiotics [84.62% (77/91) vs. 66.83% (139/208),χ2 = 9.989,P = 0.002]. Multiple logistic regression analysis showed that advanced age [odd ratio (OR) = 1.032, 95% confidential interval (95%CI) = 1.015-1.050,P = 0.000], cerebrovascular diseases (OR = 2.247, 95%CI = 1.234-4.090,P = 0.008), prolonged mechanical ventilation (OR =1.041, 95%CI = 1.014-1.069,P = 0.003), and recent hospital stay (≥2 days) within 90 days (OR = 1.968, 95%CI =1.079-3.592,P = 0.027) were the independent risk factors for polymicrobial infection. In the polymicrobial infection group, the length of ICU stay [days: 46 (22, 77) vs. 13 (7, 22),U = 3 148.000,P = 0.000] and hospital stay [days:81 (47, 118) vs. 28 (17, 46),U = 3 620.000,P = 0.000] were significantly longer, and the ICU mortality [65.93%(60/91) vs. 43.75% (91/208),χ2 = 12.463,P = 0.000] and hospital mortality [68.13% (62/91) vs. 45.67% (95/208),χ2 = 12.804,P = 0.000] were significantly higher, and on the other hand the 90-day survival rate was significantly lower than that in the monomicrobial infection group (χ2 = 8.513,P = 0.004).Conclusions The most common pathogen of ICU sepsis is gram-positive cocci. Independent risk factors for polymicrobial infections were found to be advanced age, occurrence of cerebrovascular disease, prolonged mechanical ventilation, and recent hospitalization. Polymicrobial infection is associated with longer length of ICU and hospital stay, as well as higher mortality.