Adult ; Aged ; Aged, 80 and over ; Anthracosis ; complications ; microbiology ; Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Humans ; Lung Neoplasms ; complications ; microbiology ; Male ; Middle Aged ; Pseudomonas Infections ; microbiology ; Pseudomonas aeruginosa ; drug effects

Requirement for Medical English teaching in physical medicine physicians training has been on the agenda to fit the new condition of globalization. According to the development of physical medicine in China and students English level, courses of medical English were set to match the requirements of both scientific research and clinic works. We try to improve students' medical English level through lectures in multimedia classroom and a lot of practical activities after class.

Objective To investigate the impact of hs-CRP and IVUS on major adverse cardiac event in patients who after coronary artery intermediate lesions stent implantation.Methods 82 patients with clinical diagnosis of coronary heart disease who had a segmental stenosis degree is 40％ ～ 70％ in one major coronary artery on coronary angiography,all of the patients do intravascular ultrasound,patients had minimal lumen area(MLA) of intermediate lesions ≤ 4mm2( the left main coronary artery)or≤ 6mm2( left main coronary artery) who received percutaneous coronary intervention(PCI),and the patients were divided into 2 groups,hs-CRP rise group(≥3mg/L) and hs-CRP normal group(＜3mg/L),compared the rate between the two groups in hospital and follow up periods by typical angina,nonfatal myocardial infarction,cardiac death and target-vessel revascularization and other major adverse cardiac events (MACE).Results The rate on major adverse cardiac event in hs-CRP rise group was significantly higher than the normal group(P ＜0.01 );the restenosis rate in hs-CRP rise group higher than hs-CRP normal group(P ＜0.01 ).Conclusion hs-CRP could predict the rate on major adverse cardiac event in patients with after coronary artery intermediate lesions stent implantation,the patients of hs-CRP rise group should strengthen antiplatelet,anti-inflammatory treatment etc.

Objective To evaluate the efficacy of pivot-regulating manipulations applied in traditional Chinese medicine (TCM) clinical nursing for infantile anorexia based on the meridian and acupoint theory. Methods One hundred and twenty children with anorexia were randomly divided into trial group and control group , 60 cases in each group. The control group was given spine-pinching therapy based on the conventional nursing care. The trial group was given pivot-regulating manipulations based on the conventional nursing care , and the pivot-regulating manipulations covered manipulating spleen -stomach meridian , regulating Neibagua, kneading Banmen, kneading abdomen, manipulating acupoints of Zhongwan, Tianshu and Zusanli, and pinching spine according to the deficiency-excess differentiation, once every other day and 3 times constituting one course of treatment. After treatment for 2 courses, the clinical efficacy of the two groups was evaluated. The changes in TCM symptom scores and physical examination indexes of body height, body mass, head circumference, chest circumference, height-for-age (HT/A), weight-for-age (WT/A) in the two groups were observed before and after treatment. Results(1) Five cases(3 differentiated into excess syndrome and 2 into deficiency syndrome) of the trial group dropped out and quitted from the trial, and 6 cases of the control group dropped out and quitted from the trial. (2) After two courses of treatment, the total effective rate of the trial group was 94.55％, and that of the control group was 87.04％, the difference being significant (P < 0.05). (3) After treatment, the scores of appetite and food-intake amount, complexion and lip color, water intake, restlessness, and urination as well as TCM symptom scores in both groups were improved; the WT/A of the trial group was also improved (P < 0.05 compared with those before treatment). The trial group had better effect on improving the scores of appetite and food-intake amount, complexion and lip color, and restlessness as well as TCM symptom scores than the control group (P < 0.05 or P < 0.001). The trial group also showed better effect on improving body mass, body height, head circumference, and HT/A than the control group(P<0.05). Conclusion As a nursing method based on the meridian and acupoint theory as well as syndrome differentiation and treatment, pivot-regulating manipulations are effective for the treatment of infantile anorexia by quickly starting an effect and obviously relieving the symptoms.

Objective To evaluate the effects of different doses of dexmedetomidine administered intranasally on the median effective concentration (EC50) of sevoflurane inhibiting responses to laryngeal mask airway (LMA) insertion in the pediatric patients.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients of both sexes, aged 1-3 yr, with body mass index of 20-25 kg/m2, scheduled for elective surgery under general anesthesia, were randomly divided into 3 groups: control group (group C) , dexmedetomidine 1 μg/kg group (group D1) , and dexmedetomidine 2 μg/kg group (group D2).In D1 and D2 groups, dexmedetomidine 1 and 2 μg/kg (in 1 ml of normal saline) were administered intranasally at 1 h before induction of anesthesia, respectively.Group C received the equal volume of normal saline administered intranasally.The children were separated from their parents at 45-60 min after intranasal administration and admitted to the operating room.The children inhaled 8％ sevoflurane until they lost consciousness.After loss of consciousness, the end-tidal concentration of sevoflurane was determined using the modified Dixon's up-and-down method.The initial end-tidal concentration of sevoflurane was set at 2％.The concentration was increased/decreased by 0.2％ in the next patient according to the response to LMA insertion.The patient's sedation status and with LMA acceptance were evaluated, and the patient's satisfaction with sedation and with LMA acceptance was recorded.Probit analysis was used to calculate the EC50 and 95％ confidence interval of sevoflurane inhibiting responses to LMA insertion.Results The patient's satisfaction with sedation and with LMA acceptance was significantly higher in D1 and D2 groups than in group C, and in group D2 than in group D1 (P＜0.05).The EC50 (95％ confidence interval) of sevoflurane inhibiting responses to LMA insertion was 2.03％ (1.91％-2.15％), 1.76％ (1.65％-1.87％) and 1.63％ (1.53％-1.73％) in C, D1 and D2 groups, respectively.The EC50 was significantly lower in D1 and D2 groups than in group C, and in group D2 than in group D1 (P＜0.05).Conclusion Dexmedetomidine 1 and 2 μg/kg administered intranasally can decrease the EC50 of sevoflurane inhibiting responses to LMA insertion in the pediatric patients, and 2 μg/kg produces better efficacy.

Objective To investigate the expression of programmed cell death-1(PD-1)ligands on HepG2 cell and 2.2.15 cell.Methods Culture HepG2 cell and 2.2.15 cell in vitro and stain the cells with fluorescence-labeled monoclonal antibodies specifically against PD-L1 and PD-L2,respectively.Isolate total RNA of HepG2 cell and 2.2.15 cell and detect the mRNA expressions of PD-L1 and PD-L2 by RT-PCR.Results The expression of PD-L1 on 2.2.15 cell was upregulated on the levels of both proteins and mRNA.The expression of PD-L2 in 2.2.15 cell was not detected.And neither the PD-L1 nor PD-L2 was detected in HepG2 cell.Conclusion HBV infection can upregulate the expression of PD-L1 on hepatocyte,which might contribute to the immune evasion of HBV.

ObjectlveTo evaluate the role of cannabinoid receptor 2 (CB2 receptor) in microglial injury induced by glutamate.MethodsMicroglia cells were randomly divided into 4 grups:control group (group C),microglial injury group ( group Ⅰ),specific CB2 receptor agonist AM 1241 group ( group AM1241 ) and specific CB2 receptor antagonist AM630 group (group AM630).In group C,the cells were cultured routinely for 26 h.In group Ⅰ,the cells were incubated in the culture medium containing glutamate 10 mmol/L for 24 h.In group AM1241,the cells were incubated in the culture medium containing AM1241 2 μmol/L for 2 h,and then in the culture medium containing glutamate 10 mmol/L for 24 h.In group AM630,the cells were incubated in the culture medium containing AM630 2 μmol/L for 2 h,and then in the culture medium containing glutamate 10 mmol/L for 24 h.The cell viability and release of LDH were measured.Microglial morphology was observed under microscope.Results Compared with group C,the cell viability was significantly decreased,and the release of LDH was significantly increased in groups Ⅰ,AM1241 and AM630 (P ＜ 0.05).Compared with group Ⅰ,the cell viability was significantly increased,and the release of LDH was significantly decreased in group AM1241 ( P ＜ 0.05).There was no significant difference in the cell viability and the release of LDH between groups 1 and AM630 ( P ＞ 0.05).Conclusion Glutamate induces microglial injury through inhibiting the function of CB2 receptor.

OBJECTIVETo observe the effect of transcutaneous acupoint electrical stimulation (TAES) combined dexmedetomidine on hemodynamic of intracranial aneurysmal subarachnoid hemorrhage patients undergoing intervention, and their protection for brain Injury.

METHODSTotally 108 intracranial aneurysmal subarachnoid hemorrhage patients undergoing intervention were randomly assigned to the electroacupuncture (EA) group and the control group according to random digit table, 54 in each group. All patients were anesthetized with dexmedetomidine. Patients in the EA group were needled at bilateral Neiguan (PC6), Lieque (LU7), and Yunmen (LU2). Parameter setting was as follows: The dilatational wave at 1. 5 Hz, strength 2 - 4 mA, 30 min. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) were compared between the two groups immediately after entry into the room (T0), after administration (T1), intubating (T2), resuscitation (T3), extubation (T4), and leaving the operating room (T5). Levels of S100β protein (S100β) and neuron specific enolase (NSE) were compared between the two groups at T0, immediately after surgery (T6), 6 h after operation (T7), 12 h after operation (T8), and 24 h after operation (T9).

RESULTSCompared with the same group at T0, SBP, DBP, MAP, and HR were significantly reduced in the two groups at T1-T5(P <0. 05), serum levels of S100β and NSE in the two groups were significantly increased at T6-T9 (P<0. 05). Compared with the control group at T1 - T5, SBP, DBP, MAP, and HR decreased in the EA group (P <0. 05). Compared with the control group at T6-T9, serum levels of S100β and NSE decreased in the EA group (P <0. 05).

CONCLUSIONTAES combined dexmedetomidine could effectively maintain stable hemodynamics of intracranial aneurysmal subarachnoid hemorrhage patients undergoing intervention, and regulate their serum levels of S100β and NSE.

Acupuncture Points ; Airway Extubation ; Blood Pressure ; Brain Injuries ; therapy ; Electric Stimulation ; Electroacupuncture ; Heart Rate ; Hemodynamics ; Humans ; Phosphopyruvate Hydratase ; S100 Calcium Binding Protein beta Subunit ; Transcutaneous Electric Nerve Stimulation

Objective To investigate the clinical significance of Notch-1 expression in small cell lung cancer(SCLC) and non-small cell lung cancer(NSCLC),and analyze the role of it in prognosis.Methods SP immunohistochemistry was used to detect the expression of Notch-1 antibody in 43 of SCLC and 40 of NSCLC tissues.Further analysis was carried out to interpret the association of Notch-1 antibody expression with clinicopathological features,lymph node metastasis and prognosis in SCLC.Results The positive rate of Notch-1 expression was 20.93％ ( 9/43 ) in SCLC,while 65.00％ ( 26/40 ) in NSCLC.The expression of Notch-1 antibody was associated with clinical stage and lymph node metastasis ( x2 =5.42,P ＜ 0.05 ; x2 =4.88,P ＜ 0.05respectively),but was not associated with age,sex,tumor location,tumor size ( Ps ＞ 0.05 ).Compared with NSCLC,the expression rates of Notch-1 antibody were significantly higher in SCLC ( x2 =16.50,P ＜ 0.05 ).Kaplan-Meier survival analysis indicated that the survival time of patients with positive Notch-1 expression was significantly longer than that of patients with negative staining( x2 =19.87,P ＜ 0.05 ).Cox regression analysis showed that Notch-1 antibody could significantly reduce the risk of death in patients with SCLC.Conclusion The positive expressions of Notch-1 were significantly different in SCLC and NSCLC,which linked to the clinicalstage,lymph node metastasis and poor prognosis.Accordingly,the expression of Notch-1 may have good value in diagnosis and prognosis.

Objective To investigate the correlation between the prognosis and the early lactate clearance in patients with postcardiac surgery undergoing cardiopulmonary bypass.Methods The clinical data of 73 patients who underwent postcardiotomy undergoing cardiopulmonary bypass in SuBei Hospital of Jiangsu Provience,from March 2006 to February 2010,were prospectively collected and analyzed.The collection data including:( 1 ) Preoperative factors:including gender,age,diagnosis preoperative,NYHA grade,APACHE Ⅱ score and left ventricular end-diastolic diameter.(2) Operative factors:operation time,block aorta time.(3)Postoperation factors:hemorrhage volume,mechanical ventilation time,and factors of hemodynamics and oxygen metabolism at 6 hour postoperative:heart rate(HR),central venous pressure(CVP),pulmonary capilary wedged pressure( PCWP),cardiac output index( CI),arterial blood lactic acid,6 h lactate clearance,partial pressure of oxygen( PO2 ),mixed venous oxygen saturation ( SvO2 ),oxygen delivery index ( DO2I),oxygen consume index (VO2I),oxygen extraction ratio(O2ext).Patients were divided into survival group,control group,high level of lactate clearance group( lactate clearance rate ＞ 30％ ) and low level of lactate clearance group.Firstly,the data analyzed with process of single variable analysis and some parameters,which showed the significant difference,were sorted out from two groups.Then these parameters were put to the Logistic regression analysis.Consequently,the independent risk factors of death of postcardiac surgery could be found.Results The mortality in high lactate clearance group ( 4.55％ [ 2/44 ] ) was significantly less than the low lactate group (34.48％ [ 10/29] ) ( x2 =11.889,P ＜0.01 ).The single variable analysis had shown that there were significant difference on APACHE Ⅱ score ( [ 16.9 ± 2.9 ] vs [ 19.2 ± 2.6 ],t =2.537 ),left ventricular end-diastolic diameter( [ 53.9 ± 5.6 ] mm vs [ 63.8 ± 4.6 ] mm,t =5.847 ),block aorta time ( [ 101.2 ± 34.2 ] min vs [ 122.7 ±22.7 ] min,t =2.078 ),hemorrhage volume( [464.0 ± 158.8 ] ml vs [ 603.2 ± 159.5 ] ml,t =2.773 ),mechanical ventilation time( [ 22.6 ± 5.1 ] h vs [ 28.8 ± 5.2 ] h,t =3.857 ),arterial blood lactic acid ( [ 3.5 ±1.3 ] mmol/L vs [5.1 ± 1.5 ] mmol/L,t =3.912),lactate clearance ( [38.8 ± 17.4]％ vs [ 14.6 ±9.7]％,t =4.846),and SvO2( [69.1 ±4.2]％ vs [59.2 ±6.9]％,t =5.847) (P＜0.05 or P ＜0.001)between survival group and control group.Multiple regression analysis showed that lactate clearance and left ventricular enddiastolic diameter were the two independent risk factors of death,and the odds ratio(OR) were 7.773 (95％ CI 1.364-44.306,P ＜0.05) and 15.186(95％ CI 2.758-83.162,P ＜0.01).Conclusion Early lactate clearance rate can be used as an important indicator to evaluate the prognosis of patients with postcardiac surgery undergoing cardiopulmonary bypass.