Adult ; Anemia, Aplastic ; chemically induced ; immunology ; therapy ; Benzene ; poisoning ; Cyclosporine ; therapeutic use ; Female ; Humans ; Immunity, Cellular ; Immunosuppressive Agents ; therapeutic use ; Male ; Middle Aged

Objective To study the risk factors for ventilator associated pneumonia (VAP) in ICU and pathogens antimicrobial resistance.Methods 220 patients were selected and divided into observation group (88 patients) and control group(132 patients) depending on whetherhe has VAP or not.The clinical data were reviewed to explore the risk factors.And the secretions of respiratory tract were investigated by the routine bacterial culture and drag-resistance methods to analysis the distribution of pathogens.Results The risk factors associated with VAP were COPD,mechanical ventilation,the extensive use of antibiotics,age ＞ 60 years,APACHEII score ＞ 30(P ＜ 0.01).157 bacterial were cultured,68.9％ of pathogens was Gram-negative bacteria in which Pseudomonas aeruginosa was rated as the top one,and 26.1％ of pathogens was Gram-positive bacteria in which MRSA was the majority.The results of the antibiotic resistance monitoring indicated that all Gram-positive and Gram-negative bacteria showed high drugresistance to common antibiotics.Conclusion We should control these risk factors which are closely related to VAP,and select suitable antibiotics on the basis of etiological analysis and drug-resistance.

Objective Summarize the interventional nursing experiences for patients with coronary chronic total occlucion by transraidal approach. Methods Preoperative evaluation, careful psychological nursing, perioperative observation and prevetion complications were used for 105 patients with coronary chronic total occlusion when curred by transraidal approach intervention. Results There were 97 cases had successful operation, while 8 cases failure. There were 14 cases of perioperative hypotension, 6 cases of coronary acute occlusion, 4 cases of coronary perforation and 3 cases of no- reflow. There were no radial- as-sociated complication in any patients. Conclusions Effective and careful nursing measures can prevent complications.

Objective To investigate the effects of recombinant human growth hormone on prognosis,pulmonary function and immune function in the patients with pulmonary exogenous respiratory distress syndrome (ARDS).Methods Eighty-four cases of ARDS were selected and divided into the observation group (n=42) and control group (n=42) according to the random number table.The control group was treated with the routine therapy according to the ARDS Diagnosis and Treatment Guidelines,while on this basis the observation group used recombinant human growth hormone for conducting treatment.The treatment time lasted for 7 d.The clinical effects and improvement situation of immune function before and after treatment were recorded in the two groups.Results The Murray acute lung injury score,and acute physiology and chronic health status score (APACHE Ⅱ) after treatment in the observation group were lower than those in the control group (P<0.05).The mechanical ventilation time and ICU stay of observation group were shorter than those of the control group(P<0.05).The mortality rate of the observation group was lower than that of the control group(P<0.05).The levels of vital capacity (VC),total lung volume (TLC),forced expiratory vital capacity (FVC),forced expiratory volume of vital capacity (FEV1),forced expiratory vital capacity 1 second (FEV1/FVC) and carbon monoxide (DLCO) after treatment in the observation group were significantly higher than those in the control group (P<0.05).The levels of CD3+,CD4+ and CD4+/CD8+ after treatment in the observation group were higher than those in the control group (P<0.05).The levels of interleukin-6(IL-6),interleukin-8 (IL-8) and tumor necrosis factor-a (TNF-α) after treatment in the observation group were lower than those in the control group (P<0.05).Conclusion Recombinant human growth hormone can effectively improve the pulmonary function in the patients with pulmonary exogenous ARDS,improves the immune function and is conducive to the prognosis of patients.

Objective: To explore pathogeny and clinical effect of physiotherapy in young patients with lumbar disc hemiation (LDH). Method: Eighteen young LDH patients at 20-30 years old were administered comprehensive physiotherapy including lumbar traction, pulsed short wave therapy, pulsed magnetotherapy or low frequency modulated medium frequency electrotherapy. Before and after treatment, lumbar function was assessed with JOA scale. Result: Nine patients had specific trauma history; nine patients had sedentary lifestyle; five patients worked lor more than 8h/d in standing position; four patients had body mass index (BMI) 24-28. There was no significant difference in age, BMI and JOA scores between male and female group (P＞0.05). Patients scored significantly higher after treatment (P＜0.05). The remarkable effective rate of physiotherapy was 72.22%. Conclusion: Trauma, sedentary lifestyle, standing for long time, overweight or obesity are primary risk factors of LDH for youth and should be prevented by health education. Physiotherapy is significant efficient for young LDH patients.

2?mol/L) was obvious and the inhibitive degree was nearly 100% when the concentrations of arsenic trioxide and cisplatin were 12?mol/L and 4?mol/L. 2.Higher concentrations of arsenic trioxide and cisplatin perturbed cell through S-phase and up-regulated p53 gene expressions.Conclusions The inhibitive effect of arsenic trioxide combined with cisplatin was more obvious than either one used separately; the apoptosis mechanism of ovarian cancer cell line HO-8910 is related with perturbing of S phase and up-regulating of p53 gene expression.

Objective Little is known about the influence of congenital heart disease on the phannacodynamies of neuromuscular blocking agents. The aim of this study was to compare the pharmacodynamics of rocuronium in children with cyanotic and acyanotic heart disease. Methods The study was conducted in two parts. In part Ⅰ , 36 children with congenital heart disease scheduled for open heart surgery were allocated into 3 groups (n=12) : acyanotic group; slightly cyanotic group and severely cyanotic group. Neuromuscular blockade was monitored after administration of 0.6 mg ? kg-1 rocuronium. In part Ⅱ , 40 children with congenital heart disease were allocated into acyanotic and cyanotic group ( n = 20). The children in each group were further divided into 4 subgroups of 5 patients according to the dose of rocuronium the children received : 120, 180, 240 and 300 ?g? kg-1 . The dose- response curve for neuromuscular blockade was constructed and ED50 , ED90 and ED95 were calculated. SPSS 8.0 software was used for statistical analysis.Results In part Ⅰ the onset time (the time from injection of rocuronium to 95% depression of neuromuscular transmission) was significantly longer in severely cyanotic group [(2.25 ? 1.27) Min] than in acyanotic group [(1.17 ? 0.15) min] . There was no significant difference in the duration of action and recovery time among the 3 groups. In part Ⅱ the dose-response curve shifted to the right in cyanotic group compared with acyanotic group. ED50, ED90 and ED95 were significantly higher in cyanotic group than in acyanotic group. Conclusion The onset time of rocuronium is prolonged and the sensitivity of the patients to rocuronium is decreased in patients with cyanotic heart disease.

A preliminary investigation on the serum HCV RNA in 182 patients with different chronic liver diseases and 35 blood donors was performed with "nested" polymerase chair reaction.The findings were as follows;(1)Serum HCV RNA was detected in 36.6%(34/93)cases of primary hepatic carcinoma(PHC),31.7%(20/63)cases of liver cirrhosis(LC),15.4%(4/ 26)cases of chronic hepatitis(CH)and 2.9%(1/35)blood donors.(2)Most of the HCV RNA positive cases were accompanied with positive serum HBsAg/HBV DNA.15.1%(14/93)of PHC,3.2%(2/63)of LC and 3.8%(1/26)of CH was positive only for HCV RNA.The findings suggest that about 20% of PHC are related to the coinfection of HCV and HBV,while 15% of PHC are related to HCV infection only.

Serum hepatitis C virus (HCV) RNA and HBV DNA were assayed in 38 patients with primary hepatic carcinoma (PHC) negative for all serum HBV immunological markers (HBsAg, HBsAb, HBeAg, HBeAb and HBcAb) by polymerase chain reaction (PCR). It was found that either HCV RNA or HBV DNA or both were detectable in 28 cases (73.7%) among the 38 patients. Of these patients, single HCV RNA- positive, single HBV DNA-positive and both HCV RNA and HBV DNA-positive were observed in 7(18.4%), 12(31.6%) and 9(23.7%) cases, respectively. The results suggest that (1) HCV infection may also play an important role in the development of PHC in Chongqing; and (2) about half of the PHC patients negative for all the serum HBV immunological markers are still associated with HBV infection.

Objective To investigate a novel therapeutic strategy in the treatment of lung cancer with diffuse pleural metastasis accompanied by malignant pleural effusion. Methods From December 1978 to February 2003, 55 patients of carcinoma of lung with pleural metastasis underwent the comprehensive therapy characterized by pleuropneumonectomy. A follow-up of all the patients after hospital discharge was conducted. Results Death due to complications was found in 2 out of the 55 patients, but remission and significant improvement of symptoms were found in the rest. A follow-up period ranging from 1 to 25 years revealed that 48 patients survived for 5-40 months (median survival time: 14 months), and 5 patients were still living and well. Conclusion Strict control of the surgical indications and radical removal of the malignant tumor can improve the quality of life and prolong the survival time of patients, even there is already metastasis to the pleura.