Objective To study the effect of early pulmonary surfactant (PS) treatment on oxygenation in neonates with acute respiratory distress syndrome (ARDS). Methods Clinical data of neonates with ARDS were retrospectively analyzed. All neonates with ARDS were divided into control group and treatment group. Neonates in treatment group were given PS at a dose of 70-100 mg/kg through the endotracheal tube. Results Among 64 neonates with ARDS, 18 neonates in treatment group were treated with PS, while other interventions were same with 46 neonates in control group. The PaO2/FiO2 and ventilation efifciency index were statistically higher in treatment group than those in control group at 6 h, 12 h, 24 h and 48 h (P<0.05). The oxygenation index and respiratory index were statistically lower in treatment group than those in control group at the same time points (P<0.05). Compared with control group, the treatment group also had a signiifcantly shorter duration of assisted ventilation and oxygen treatment (P<0.05). Conclusions Early treatment with PS in neonates with ARDS could improve the pulmonary compliance and oxygenation, and reduce the duration of assisted ventilation and oxygen treatment, and thus yield better prognosis.

Objective To summarize anesthetic management for 56 patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods Recorded and analyzed the hemodynamie changes of 56 patients undergoing OPCABG including heart rate (HR),rate-pressure product (RPP), mean arterial pressure(MAP), mean pulmonary artery pressure(MPAP), central venous pressure (CVP), cardiac output (CO) and mixed venous oxygen saturation when left anterior descending (LAD), right coronary artery (RCA), diagonal (DiAG) and left circumflex coronary artery (LCX) was anastmosed. Results The patients undergoing OPCABG had hemodynamic fluctuation during vascular anastomosis, mainly showing MAP and CO decreased, CVP increased. The change was especially significant when the LCX or RCX was anastmosed. The based value, when LAD and RCA anastmosed of MAP were (82.0±11.7) mm Hg(1 mm Hg = 0.133 kPa), (60.1±11.5) mm Hg and (58.4±12.1) mm Hg, CO were (4.2±1.2) L/min, (3.1±0.7) L/min and (3.2±0.6) L/min, CVP were (5.6±2.6) cm H2O (1 cm H2O=0.098 kPa), (9.6±4.4) cm H2O and (9.2±3.6) cm H2O. Conclusion The hemodynamie changes during OPCABG,especially in LCX and RCA anastmesed are transient and well tolerated under suitable anesthetic management.

Objective To study the oxygenation of the pulmonary surfactant replacement therapy for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in neonates.Methods Ninetyeight eligible neonates with ALI and ARDS were divided into two groups,treatment group (n =30) and control group(n =68).Thirty infants in treatment group were injected with pulmonary surfactant 70 ～ 100 mg/kg via tracheal intubation.The rest of the treatment measures were same in treatment and control group.Results There were no differences between the two groups in gender,gestational age,birth weight and ALI/ARDS.After the pulmonary surfactant replacement therapy for ALl and ARDS,the PaO2/FiO2 and ventilator efficiency index were higher in treatment group than that in control group at 6 h,12 h,24 h,48 h;the oxygenation index and respiratory index were shorter in treatment group than that in control group at the same time.The differences at all time points were statistically significant (P ＜ 0.05).The treatment group also had a significantly shorter duration of assisted ventilation[(66 ± 13) h vs (80 ± 18) h,(82 ±26) h vs (101 ±36) h] and oxygen treatment time [(86±13) h vs (104± 16) h,(103 ±25) h vs (125 ±29) h] (P ＜0.05).Conclusion The application of the pulmonary surfactant replacement treatment in neonates with ALI and ARDS could improve rapidly in dynamic compliance and oxygenation,decrease duration of assisted ventilation and supplemental oxygen administration,thus yield better prognosis.

This study was conducted under the background of the internationalization of traditional Chinese medicine (TCM) terminology. Current TCM symptom terminology related to sweat was taken as basis in the extended study. The ICD classification of multiple axis and hierarchical level was used as guidance thought. This paper proposed the principle of detailed classification of TCM sweat symptoms and finally made classification rules for TCM sweatsymptoms. This study has promoted the development of TCM terminology standardization.

Objective: To investigate the alteration of red cell deformability (RCD) and adenosine triphosphatase (ATPase) activity of cell membrane in essential hypertensive (EH) patients and essential hypertension patients complicated with cerebral infarction (HCI). Methods: Twenty healthy individuals, 30 EH patients and 30 HCI patients were selected as subjects. The erythrocyte deformability indexes (DI)、 Na+, K+-ATPase and Ca2+ATPase activities were examined. Results: (1) EH patients had significantly higher DI, lower ATPase activity as compared to healthy individuals. There were significantly negative correlation between DI and ATPase activity, and a significantly positive correalation between DI and diastolic blood pressure in EH patients; (2) There was significantly higher DI, lower ATPase activity in HCI patients than those in EH patients. There was significantly negative correlation between DIand ATPase activity in HCI patients. Conclusion: (1) RCD decreases in EH patients, and RCD is correlated to the decreased ATPase of cell membrane and elevated blood pressure; (2) The decreased RCD level may be related to the occurrence of HCI.

Objective To investigate the mechanisms of angiotensinⅡ receptor blockade in protection against kidney lesion in hypertensive rats.Methods The investigation was comprised with normotensive control (WKY) and hypertensive group (SHR) which included treated and untreated group. Relevant index such as blood pressure and ultrastructural changes in glomerulus with transmission electronic microscope were acquired in three-month old and eight-month old. Losartan was administrated with 20mg?Kg -1 ?d -1 in treated group.Results The volume density of vessel endothelium, mesangial cells and mesangial area of SHR was significantly larger than that of WKY(P

Objective To observe the influence of serum containing Tongmai on the anoxic myocardial cell. Methods The serum containing Tongmai effective components was extracted and used to interfere the anoxic myocardial cell, then the concentration of the LDH and troponin I in the culture medium of the cardiac myocyte was measured. Results The concentration of LDH and troponin I increased significantly in the culture mediun of the anoxic cardiac myocyte. The intervention of the serum containing Tongmai can significantly decreased the concentration of LDH and troponin I in the culture medium of the anoxic cardiac myocyte. Conclusion Tongmai can protect the cardiac myocyte from anoxic damage.

Objective:To determine distribution of fungal florae of candial balanoposthitis (CBP),the relatioship between antibiotics administration and candial infection and the major source of opportunistic pathogens.Methods:The fungal strains were collected and identified,and the history of antibiotic administration was reviewed.Results:①Foreign fungi were predominant pathogens of CBP;②Dysbacteriosis induced by antibiotics stimulated the growth of foreign fungi,which resulted in CBP;③There was a positive relationship between fungal distribution of male patients and their sexual partners.Conclusion:In order to reduce the incidence of CBP safe coition and reasonalbe administration of antibiotics should be emphasized.

Objective:To study how to guide the individual dose of clopidogrel in line with the genetic testing results. Methods:Clinical pharmacists decided how to optimize the prescription of clopidogrel according to the genotype combined with the drug metabolism and drug interactions for three patients respectively with slow clopidogrel metabolism,intermediary metabolism and super fast metabolism. Results:The slow clopidogrel metabolism patient with subacute stent thrombosis after half a month of coronary stenting was switched to orally administrate with ticagrelor. The super fast metabolism patient suffered from repeatedly subcutaneous hemorrhage with antiplatelet therapy was suggested to lower the dose of clopidogrel,temporarily withdraw Maixuekang capsules and conventionally administrate with vitamin C tablets orally. The intermediary metabolism patient with late stent thrombosis co-treated with lansoprazole was suggested to increase the dose of clopidogrel or use ticagrelor instead,and when it was necessary,panxitorazole,ray Bella or the other ranitidine acid suppression drugs such as ranitidine could be considered. Conclusion:Through genetic testing and drug interactions,clinical pharmacists guide the clinical use of clopidogrel and the optimization of antiplatelet therapy.

AIM: To investigate the relation between cytosolic calcium and glomerular injury in hypertension. METHODS: The normotensive control (WKY) and spontaneously hypertensive rat group(SHR) with or without treatment (losartan 20 mg?kg -1 ?d -1 ) were compared. Intralymphocytic free calcium level and ultrastructural changes in glomerulus were observed at three and eight months, respectively. RESULTS: The results demonstrated early impairment in glomerulus and elevation of cytosolic calcium at three months in SHR group, at eight months, aggravation of impairment in glomerulus correlating with calcium elevation was shown. Losartan significantly attenuated the above pathologic changes. CONCLUSION: Calcium-overload state was not only related to blood pressure and vessel impairment, but also associated with glomerular injury, which could be reversed by losartan.