Acute Disease ; Humans ; Respiratory Tract Infections ; diagnosis ; etiology ; microbiology ; virology

This research is to explore the feasibility of construction of real-time network teach-ing platform in anesthesia resident standardization training. The real-time network teaching were car-ried out by platformconstruction and teaching organization. The teaching effect was evaluated. Using the real-time network teaching platform with the four functions of learning knowledge, cultivating ability, communication and supervision can achieve good teaching effect. It was a beneficial supplement of traditional teaching.

Humans ; Recurrence ; Respiratory Tract Infections

Objective To study the relationship between tacrolimus blood level/dose and the genotype of CYP3A5 at 6th month after lung transplantation.Method Forty-six cases of lung transplant recipients who received the surgery between January 1st,2011 and January 1st,2013 served as the research subjects,and the genotypes of these patients were measured.These patients were divided into 3 groups (CYP 3A5 * 1 * 1,CYP 3A5 * 1 * 3,CYP 3A5 * 3 * 3) according to their different genotypes.The dose of tacrolimus and daily intake were detected at 6th month after surgery in each group,then the level/dose of tacrolimus was calculated.Result In all 46 recipients,5 of them were CYP 3A5 * 1 * 1 homozygous genotype,20 CYP 3A5 * 1 * 3 heterozygous genotype and 21 CYP 3A5 * 3 * 3 homozygous genotype.Under the condition of holding tacrolimus blood level between therapeutic range,there was significant difference in the dose of tacrolimus between the CYP3A5 * 1/ * 1 and * 1/* 3 versus * 3/* 3 genotypes (P＜0.01),but there was no significant difference between CYP3A5 * 1/* 1 genotype and * 1/* 3 genotype.Conclusion Tacrolimus dosing in lung transplant patients is associated with CYP 3A5 gene polymorphisms.

Objective:To investigate the resting energy expenditure of children with mechanical ventilation and analyze their association with anthropometric indicators (height, weight, and body mass index) and serum protein markers (pre-albumin, albumin, transferrin, and retinol).Methods:An observational study was held in Pediatric Intensive Care Unit(PICU) of Beijing Children′s Hospital, Capital Medical University, from August 2015 to April 2016.Critically ill children with mechanical ventilation were enrolled in this study.Inclusion criteria were as follows: (1)pediatric critical illness score<90 scores or meet the United States PICU admission criteria; (2)age>29 days, <18 years old; (3)mechanical ventilation>24 hours; (4) tidal volume >60 mL.Resting energy expenditure was determined by US Med Graphic Company CCM/D energy metabolism test system.German Famed Zywier intensive care bed with weight scale weighing, uniform measuring bed or meter measuring height, automatic biochemical analyzer and radioimmunoassay was adopted for the determination of albumin, pre-albumin, transferrin, retinol binding protein.SPSS 20.0 software was applied for carrying out Pearson line analysis correlation. Results:A total of 68 children were included in the study, including 36 males and 32 females, body weight (22.34±14.89) kg, height (122.23±14.89) cm, resting energy consumption (784.63±278.25) kcal(1 kcal=4.185 kJ), and resting energy consumption per kilogram of body weight (48.80±31.26) kcal.In anthropometric indicators, resting energy expenditure was significantly positively correlated with height, body weight ( r=0.764, 0.734, all P<0.05), a low positive correlation with body mass index( r=0.396, P<0.05). In serum proteomics, resting energy expenditure was negatively correlated with pre-albumin, transferrin ( r=-0.318, -0.282, all P<0.05), and a moderate negative correlation with retinol protein ( r=-0.505, P<0.05), while without correlation with albumin ( r=-0.075, P>0.05). Conclusions:The height, weight and serum proteomics of children with mechanical ventilation may affect resting energy expenditure.

AIM: To investigate protect effect of the NO donating-oleanlic acid derivatives on hepatic fibrosis in rats. METHODS: The rat model with early hepatic fibrosis was induced by carbon tetrachloride (CCl_4). ZCⅡ_2 at the dose of 128 and 64 mg?kg -1 had been given orally for 30 days. Serum level of the total protein (TP), albumin (ALB), the albumin/globulin (A/G) and ALT, AST. The hyaluronic acid (HA), laminin (LN), the procollagen type Ⅲ (PCⅢ) and the level of MDA, GSH-Px in liver tissues were determined. Pathological examination to reveal the extent of liver damages was observed. [WTHZ]RESULTS: ZCⅡ_2 at the dose of 128 mg?kg -1 increased the serum TP, ALB, and A/G and decreased HA, LN, PCⅢ, ALT, and AST more significantly than the model group, and hepatic pathological injury was abated to some degree. CONCLUSIONS: ZCⅡ_2 at the dose of 128 mg?kg -1 can attenuate liver damages, protect against lipoperoxidation and attenuate hepatic fibrosis induced by CCl_4.

Because the medical treatment mode is being transformed into 'patients as orientation',our hospital introduces queuing system,transformsand redesigns programs of registration system,outpatient doctor workstation system,outpatient charge system and outpatient dosage system.By using liquid crystal display and automatic phonetic call,the outpatient procedure is optimized with a friendly service environment so as to improve the work efficiency and enhance the overall administration and service quality.

Objective To explore the clinical application of GlideScope video laryngoscope combined with fiberoptic bronchoscope for double-lumen endobronchial tube intubation in patients with difficult glottis exposure.Methods Forty patients undergoing scheduled for thoracic surgery (24 males,1 6 females,aged 24-78 years,falling into ASA Ⅰ or Ⅱ,Mallampati classification Ⅲ or Ⅳ, were randomly divided into two groups (n=20 each):GlideScope video laryngoscope combined with fiberoptic bronchoscope group (group GF)and Macintosh laryngoscope group (group M).In group GF,GlideScope video laryngoscopy combined with fiberoptic bronchoscope was used to guide the double-lumen tube bronchial intubation and then bronchoscope was used to check the placement of the tube.In group M,the double-lumen endobronchial tube was intubated with conventional macintosh laryngoscope,and then the placement of the tube was checked by bronchoscope.The results of the Cormack and Lehane grade measuring the degree of glottic opening during laryngoscopy,the intuba-tion time consumed,one-time intubation success rate,patients manoeuvre needed to aid tracheal intu-bation and endotracheal intubation related complications within 48 hours after operation were recorded and compared between the two groups.Results Compared with group M,the Cormack and Lehane grade was significantly better (P < 0.01 ), intubation time consumed was significantly shorter [(104.3±1 1.1)s vs.(138.6 ± 33.0)s](P < 0.01 ),one-time intubation success rate was higher (90% vs.55%)(P <0.05 ),fewer patients needed manoeuvre to aid tracheal intubation (20% vs. 90%)(P < 0.01 )and postoperative complications of hoarseness and pharyngalgia within 48 hours were significantly fewer (5% vs.35%,25% vs.75%)in group GF(P <0.05 ).Conclusion Com-pared with conventional method, GlideScope video laryngoscope combined with fiberoptic bronchoscope used to guide double-lumen endobronchial tube intubation in patients with difficult glottis exposure may improve the success rate of intubation,reduce the stress response of intubation and postoperative complications of hoarseness and pharyngalgia.

Aim: To study the effects of astragaloside IV on experimental ventricular remodeling in mice and its mechanism from matrix metalloproteinase aspect.Method: Ventricular remodeling in mice was induced by con-secutively subcutaneous injection of isoproterenol for 14 days.Astragaloside IV(40,80 mg/kg)and propranolol(40 mg/kg,positive control)were administered by gavage to mice.Echocardiography was used to observe the left ventricular end diastolic diameter(LVIDd),left ventricular end systolic diameter(LVIDs),fractional shortening(FS)and ejection fraction(EF).The myocardial pathological pattern was detected by HE staining.Expressions of matrix metalloproteinases(MMP2,MMP9)and tissue inhibitor of metalloproteinases(TIMP1,TIMP2)mRNA in myocardium were detected by RT-PCR.Activities of MMP2 and MMP9 were assayed by zymography.Results:Compared with those of control mice,LVIDd and LVIDs were increased,FS and EF were decreased in the model group.Myocardial injury and fibrosis existed in histop at hological slices of the model group.In addition,the mRNA expressions and activities of MMP2 and MMP9 were increased in the model group.However,there were no markable changes to TIMP1 and TIMP2.Treatment with astragaloside IV reduced LVIDd and LVIDs,increased FS and EF,attenuated myocardial injury,and down-regulated mRNA expressions and activities of MMP2 and MMP9 compared with the model group.Conclusion: Astragaloside IV can greatly improve ventricular remodeling and dysfunction via decreasing MMP2 and MMP9 mRNA expression and activities in cardiac ventricles.