OBJECTIVETo observe the clinical significance of nitric oxide (NO) and 8-isoprostane (8-isoPG) changes in exhaled breath condensate ( EBC) of acute respiratory distress syndrome (ARDS) patients after treated by Qingfei Decoction (QD).

METHODSTotally 48 ARDS patients receiving mechanical ventilation were equally assigned to the QD treatment group and the control group by random digit table. EBC specimens were collected by modified Ecoscreen breath condensate collector (German JAEGER Company) on the first day and the fifth day after confirmed diagnosis of ARDS. Concentrations of NO and 8-isoPG in EBC were measured by ELISA. The oxygenation index and APACHE II scores were recorded at the same time.

RESULTS(1) The fatality rate in the QD treatment group was lower than that in the control group (8.3% vs 37.5%, P < 0.05). (2) After treatment NO and 8-isoPG concentrations in EBC were lower in the QD treatment group (34.49 ± 5.67 µmol/L, 30.09 ± 7.89 ng/L) than in the control group (39.78 ± 9.27 µmol/L, 35.65 ± 8.90 ng/L; P < 0.05). (3) After treatment improved oxygenation index value was higher in the QD treatment group than in the control group (120.88 ± 35.16 vs 101.50 ± 37.70, P < 0.05). After treatment APACHEII scores was lower in the QD treatment group than in the control group (6.21 ± 3.51 vs 10. 26 ± 4.33, P < 0.05).

CONCLUSIONTreatment of ARDS patients by QD was favorable in controlling inflammation, alleviating lung injury, and improving clinical efficacy.

Breath Tests ; Dinoprost ; analogs & derivatives ; analysis ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Inflammation ; Nitric Oxide ; analysis ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; drug therapy

Adult ; Blast Injuries ; therapy ; Explosions ; Humans ; Male ; Multiple Trauma ; therapy

OBJECTIVENoninvasive method for estimating the pulmonary vascular resistance (PVR) was used in patients waiting for two staged Fontan procedure to observe the relationship between estimated PVR and surgical results.

METHODSThirty-three candidate patients for two staged Fontan procedures were randomly selected for this trial. Preoperative hemoglobin (HGB), hematocrit (HCT) and pulse oxygen saturation (SpO2) were measured. Estimated PVRs were then calculated by the regression equations. The cases were divided into three groups of low risk group with PVR less than 2.4 wood, high risk group with PVR between 2.4 to 3.2 wood, and extremely high risk group with PVR more than 3.2 wood. The incidences of postoperative low cardiac output and multi-organ failure were compared. Simultaneously, the cases without or with postoperative severe low cardiac output and multi-organ failure after operation were divided into two groups. The preoperative HGB, HCT and estimated PVR among the groups were analyzed.

RESULTSThe rates of postoperative severe low cardiac output and multi-organ failure were 10.0%, 32.4% and 63.6% for the patients of low, high and extremely high risk groups respectively. The difference was significant (P < 0.01). The preoperative HGB, HCT, SpO2 and PVR were all significantly different between the patients without or with postoperative severe low cardiac output and multi-organ failure. The PVR (HGB) were (2.53 +/- 0.56) wood and (3.24 +/- 0.58) wood respectively. The PVR (HCT) were (2.59 +/- 0.58) wood and (3.21 +/- 0.79) wood respectively. The PVR (SpO2) were (2.22 +/- 0.55) wood and (2.93 +/- 0.58) wood, respectively. The differences were all significant (t = 3.25, 2.52 and 3.33 respectively, P < 0.01 or 0.05).

CONCLUSIONSPreoperative estimated PVRs calculated by HGB, HCT and SpO2 were comparable with the postoperative results. Thus, the invasive preoperative estimation of pulmonary vascular resistance could be a method in estimating the surgical indication and predicting the surgical result for two stage Fontan procedure.

Adolescent ; Cardiovascular Abnormalities ; physiopathology ; surgery ; Child ; Child, Preschool ; Contraindications ; Female ; Fontan Procedure ; methods ; Humans ; Male ; Treatment Outcome ; Vascular Resistance

Objective To explore inhibition of amlodipine on myocar-dial cell injury induced by ischemia reperfusion .Methods Thirty Wistar rats were randomly into three groups: sham operation group ( n =10 ) , model group group ( n =10 ) , test group ( 2 mg? kg -1 amlodipine , n=10).The model group and test group were made by ligation of left anterior descending coronary artery to make the model of myocardial ischemia reperfusion.Rats in each group were administered 7 d before ligation.Cell apoptosis was examed by flow dual staining method .The activity of cysteinyl aspartate specific proteinase 3 ( Caspase 3 ) was measured by spectrophotometry .The activation of phosphatidylinositol 3 kinase ( PI3K)/protein kinase B ( AKT) signalling pathway, B-cell lymphoma-2 ( Bcl-2 ) , Bcl-2 associated X protein ( Bax ) were assayed by Western blot .Results Compared to sham operation group on early and late myocardial cell apoptosis , myocardial cell apoptosis with ( 2.34 ±0.35 )%, (3.58 ±0.39 )%, that on early and late myocardial cell apoptosis were increased with ( 15.69 ±1.14 )%, (24.74 ±2.56)%in model group ( P <0.05 ) .Compared to sham operation group on the activity of Bax with (0.18 ±0.01) and Caspase 3 activity with (1.00 ±0.10), the expression of Bax express with (0.62 ±0.06) and Caspase 3 activity with (3.98 ±0.18) in model group were increased (P<0.05).Compared to sham operation group on the expre-ssion of Bcl-2 with (0.99 ±0.10 ) and expression of PI3K with (0.89 ±0.06 ), on the expression of Bcl-2 with (0.14 ±0.01) and expression of PI3K with (0.18 ±0.01) in model group were decreased (P<0.05). Compared to sham operation group on phosphorylation of AKT with ( 0.95 ±0.10 ) , the phosphorylation of AKT in model group with (0.13 ±0.01 ) was decreased ( P<0.05 ).Compared with model group , test group could change the variation on the early and late myocardial cell apoptosis with ( 5.23 ±0.13 )%, ( 8.09 ±0.35 )% while on the Caspase 3 activity with ( 1.47 ±0.14 ) ( P<0.05 ) .Conclusion These results suggested that amlodipine inhibited myocardial ischemia reperfusion injury, which was related to activition PI3K/AKT signal pathway.

Objective To evaluate the implementation effect of the clinical nursing pathway on patients with cerebral hemorrhage by using the Meta-analysis.Methods The databases of WanFang Data、CMA、CHDL and CBM were searched.The controlled studies comparing clinical nursing pathway and traditional nursing were included.Data collection and literature evaluation were performed by two reviewers independently.RevMan 5.0 was used for the Meta-analysis.Results Totals of 12 literatures were included in Meta-analysis.The results showed the statistical difference between clinical nursing pathway and traditional nursing for cerebral hemorrhage's patients in average length of stay,average hospitalization expenses,patients' satisfaction,patients' health education awareness and the incidence of complication (P ＜ 0.01 ).However,most trials included in the review were of low quality.Conclusions The clinical nursing pathway is beneficial in implementation effect comparing with traditional nursing.But there are a higher risk of bias in the literatures,the results need a large number of clinical nursing practice and higher quality literatures to support.

The study was purposed to explore the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) combined with Imatinib for treatment of Philadelphia chromosome positive acute lymphoblastic leukemia (Ph(+)ALL) patients. From 2007 to 2008, 3 patients with Ph(+)ALL were treated with allogeneic hematopoietic stem cell transplantation and Imatinib, and the follow-up ended at Oct 21(st) 2009. 1 patient received HSCT from matched sibling donor and 2 patients from haploidentical related donors. All 3 patients achieved complete remission before transplantation and were treated with Imatinib for distinct time at different periods before and/or after transplantation. The level of bcr/abl mRNA was monitored using real-time PCR. The results showed that all 3 patients achieved stable engraftments without severe transplantation related complications. The level of bcr/abl mRNA declined and achieved zero level finally. In conclusion, the allo-HSCT combined with Imatinib is an effective therapy regimen for Ph(+)ALL patients.
Adolescent ; Adult ; Benzamides ; Combined Modality Therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Imatinib Mesylate ; Male ; Piperazines ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; therapy ; Pyrimidines ; therapeutic use ; Transplantation, Homologous ; Treatment Outcome

Objective To explore the application of autoregressive integrated moving average (ARIMA) model in peripherally inserted central catheter (PICC) nursing outpatient amount and to study its regularity for forecast.Methods PICC nursing outpatient amount in our hospital from January 2008 to December 2012 was chosen as the study object.ARIMA model was built by stationary sequence,model identification,parameter estimate and model diagnosis to fit and forecast.Results PICC nursing outpatient amount had characteristics of long-term growth trend and seasonality.ARIMA (1,1,1) (0,1,1) 12 model had good fitness to the PICC nursing outpatient amount with autoregressive coefficient (AR1 =0.314),moving average coefficient (MA1 =0.996),seasonal moving average coefficient (SMA1 =0.399) and constant term (C =0.004),all of which were statistically significant (P ＜ 0.05).Goodness of fit R2 =0.787,Box-Ljung =8.117 (P =0.919),and predicting error was white noise.It was predicted that outpatient amount in 2013 would continue to increase steadily.Conclusions ARIMA model is suitable for hunting variation of PICC nursing outpatient amount and grasping the future trend.Application of autoregressive integrated moving average (ARIMA) model will provide not only reference for hospital administrators to learn about variations,but also a new way to predict the future development of PICC nursing outpatient.

OBJECTIVETo investigate the efficacy and safety of diisopropylamine dichloroacetate in the treatment of nonalcoholic fatty liver diseases (NAFLD).

METHODSA randomized, double-blind, dose-paralleled control trial was carried out with NAFLD patients. The patients were randomly assigned to 2 groups treated with either a high dosage (120 mg/d) or a low dosage (60 mg/d) of diisopropylamine dichloroacetate for 8 weeks and the efficacy and safety of the drug were examined.

RESULTS127 cases were recruited for the trial, 63 in the high dosage group, and 64 in the low dosage group. No case dropped out in the trial but four cases were eliminated (4/127, 3.1%). The final number in this trial was 123, with 61 in the high dosage group and 62 in the low dosage group. After 8 weeks of treatment, the overall improvement of clinical symptoms in the high dosage and in the low dosage group was 87.8% and 79.6%, respectively. ALT normalization was found in 55.7% and 69.4% of the cases in the two groups, serum lipids were lowered in 67.2% and 67.7% and ultrasound grading of the liver alteration severity was lowered in 51.7% and 43.5% in the two groups. The differences found between the two groups were of no statistical significance. One case from each group was found having an adverse drug reaction of dryness of the mouth (1.6%). No severe adverse drug reactions were found.

CONCLUSIONDiisopropylamine dichloroacetate could be used as a safe and effective drug in the treatment of nonalcoholic fatty liver diseases.

Adult ; Double-Blind Method ; Fatty Liver ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Quaternary Ammonium Compounds ; administration & dosage ; adverse effects ; therapeutic use

OBJECTIVETo examine the effect of fractioned ionizing radiation on the expression of hypoxia inducible factor-1alpha (HIF-1alpha) and multidrug resistance (MDR1) in human esophageal cancer cells.

METHODSThe mRNA and protein levels of HIF-1alpha and MDR1 in esophageal caner EC9706 cells incubated in the presence of 150 micromol/L CoCl(2) were measured before and after the irradiation by quantitative RT-PCR and Western blotting, respectively. The chemosensitivity and radiosensitivity of the cells were analyzed by MTT assay and clone formation assay.

RESULTSMDR1 and HIF1alpha expressions were significantly up-regulated in the cells following hypoxia or irradiation (P<0.05). The surviving cell fraction in the exclusive irradiation group was significantly lower than that irradiation+hypoxia group (P<0.05). Compared with exclusive hypoxia group, MDR1 and HIF1alpha expressions were decreased significantly in irradiation+hypoxia group (P<0.05). HIF1alpha expression showed a positive correlation to MDR1 expression (P<0.01).

CONCLUSIONHypoxia is an important factor to induce resistance to chemo- and radiotherapy. Low-dose fractioned irradiation can lower MDR1 and HIF1alpha expressions in esophageal cancer cells, which should be considered when combining radiotherapy chemotherapy for esophageal cancer patients.

ATP Binding Cassette Transporter, Sub-Family B ; ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; metabolism ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; Cell Line, Tumor ; Dose Fractionation ; Esophageal Neoplasms ; pathology ; radiotherapy ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Radiation, Ionizing

OBJECTIVETo compare the diagnostic accuracy of (99)Tc(m)-MIBI SPECT/CT and (18)F-FDG coincidence SPECT/CT for solitary pulmonary nodules.

METHODSA total of 88 cases suspected of solitary pulmonary nodules were analyzed retrospectively, of whom 36 were examined with (18)F-FDG coincidence SPECT/CT and 52 with (99)Tc(m)-MIBI SPECT/CT. The nature of the solitary pulmonary nodules (malignant or benign) were determined according to the pathological or follow-up (>2 years) results. The diagnostic accuracy of the two modalities for solitary pulmonary nodules was evaluated by ROC curve. The correlation of the lesion size and pathological grade determined by the two modalities with the L/N ratio was assessed using Spearman correlation analysis.

RESULTS(18)F-FDG coincidence SPECT/CT and (99)Tc(m)-MIBI SPECT/CT showed a similar area under curve (AUC) of the L/N ratio (0.92 vs 0.88, P=0.565) with diagnostic sensitivities of 76.92% (20/26) and 80.77% (21/26) and specificities of 100% (10/10) and 88.46% (23/26), respectively. For solitary pulmonary nodules with lesion diameter ≤2 cm, the AUC was 1.00 with (18)F-FDG coincidence SPECT/CT and 0.90 with (99)Tc(m)-MIBI SPECT/CT (P=0.746), while for nodules beyond 2 cm but below 3 cm, the AUCs were 0.79 and 0.89, respectively (P<0.001). In either of the two modalities, correlation analysis revealed no correlation of the L/N ratio with the pathological grade of the malignant lesions (P=0.771 and 0.077, respectively). The L/N ratio was not correlated with the size of the malignant lesion detected by (99)Tc(m)-MIBI SPECT/CT (P=0.516) but was significantly correlated with the size of the malignant lesions detected by (18)F-FDG coincidence SPECT/CT (P=0.016).

CONCLUSION(99)Tc(m)-MIBI SPECT/CT has a greater diagnostic accuracy than (18)F-FDG coincidence SPECT/CT for solitary pulmonary nodules with lesion a diameter beyond 2 cm, and is therefore the primary choice for low-income patients.

Area Under Curve ; Fluorodeoxyglucose F18 ; chemistry ; Humans ; ROC Curve ; Radiopharmaceuticals ; Retrospective Studies ; Sensitivity and Specificity ; Solitary Pulmonary Nodule ; diagnostic imaging ; Technetium Tc 99m Sestamibi ; chemistry ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed