Objective To analyze the correlative factors of tracheal stenosis after percutaneous tracheostomy,and to explore its contermeasures.Methods Two hundreds and eighty-six patients from February 2006 to June 2012 with percutaneous tracheostomy were selected.Five correlative factors including machinery ventilation time after operation,airway infection repeatedly,irrational use of ghcocorticoid,high position of tracheotomy and operation improper method were analyzed through Logistic regression analysis.Results Tracheal stenosis occurred in 43 cases,and the incidence rate was 15.03％ (43/286).Multivariable analysis results showed that machinery ventilation time after operation for too long (x2 =21.76,P ＜ 0.01),airway infection repeatedly (x2 =18.21,P ＜ 0.01),irrational use of glucocorticoid (x2 =9.65,P ＜ 0.01),high position of tracheotomy (x2 =4.51,P ＜ 0.05) and operation improper method (x2 =4.33,P ＜ 0.05) were associated with postoperative concurrent tracheal stenosis.Conclusions There are many factors coreelate to tracheal stenosis after percutaneous tracheostomy,in which the machinery ventilation time after operation and airway infection repeatedly are the main reasons,and irrational use of glucocorticoid,high position of tracheotomy and operation improper method are secondary causes.

OBJECTIVE:To establish HPLC method for determination of the content of paeoniflorin in Weile capsules.M_ ETHODS:Paeoniflorin was separated on Hypersil C 18 column by using acetonitrile-0.1%phosphoric acid(18∶32)as mobile phase and230nm as UV detection wavelength.RESULTS:There was a good linear relationship between the concentration of paeoniflorin and absorption area value in range of0.25?g～2.5?g.The average recovery was97.9%(RSD=1.09%,n=5). CONCLUSION:The method is highly reproducible and accurate.

LAD(OR=1.209). Conclusion Left atrial diameter was independent risk factor for ischemic stroke in hypertensive patients.

Screening of CHD of infants (11 178) born from May 1st 2012 to April 30th 2013.92 infants were screening positive,68 were diagnosed.The detectable rate of CHD was 6.08‰,while boys were 3.31‰,girls were 2.77‰.68 CHD patients,the top three were VSD(2.14‰),PDA(1.34‰) and ASD (0.89‰).In these infants,detectable cardiac souffle were 61,abnormal pulse oximetry were 40.The detectable rate of CHD among infants was identical compare the average level of whole country,but the distributional characteristics was disparity.The screening of CHD was feasible,and cardiac souffle and pulse oximetry were recommended.

The target therapeutic agents of HER-2 extracellular ligand-binding domain have become the core of breast cancer research. A small peptide molecule and an anti-HER2 extracellular domain monoclonal antibody conjugated with protein toxins, radioisotopes, and chemotherapeutic drugs (immunoconjugate) can improve efficacy and reduce systemic toxicity. Vaccines based on HER-2 extracellular region should protect patients from HER-2-overexpressing breast cancer growth. In this review, studies on targeted-block therapies of the HER-2 extracellular ligand-binding domain in breast cancer were discussed to provide references for clinical applications.

Objective To investigate the effect of potassium sodium dehydroandroandrographolide succinate injection on helper T cells in peropheral blood and the content of products of oxidative stress in patients with pulmonary infection.Methods 80 community patients with acquired pneumonia in our hospital were selected as the research subjects.They wererandomly divided into observation group and control group,40 cases in each group.The control group was treated with routine treatment of community-acquired pneumonia,patients in the observation group were given conventional treatment combined with potassium sodium dehydroandroandrographolide succinate injection.The peripheral blood T cell subsets,inflammatory cytokines and oxidative stress were compared in two groups.Results After treatment,malondialdehyde,advanced oxidation protein products of the observation group were (14.61 ± 1.65)U/L,(42.67 ± 5.62)μmol/L,respectively,which were lower than those of the control group.Glutathione peroxidase,superoxide dismutase of the observation group were (243.57 ± 33.64) μg/mL,(21.63 ± 3.78) μg/mL,respectively,which were higher than those of the control group,the differences were statistically significant(t =15.155,15.432,7.651,4.726,all P ＜ 0.05).After treatment,Thl7 of the observation group was (1.03 ± 0.15) ％,Thl7/Treg was (0.21 ± 0.03),which were lower than those of the control group,and Treg was higher than that of the control group,the differences were statistically significant (t =7.315,14.805,4.541,all P ＜0.05).The total effective rate of the observation group was 87.50％,which was significantly higher than 77.50％ of the control group (x2 =2.385,P ＜ 0.05).Conclusion Potassium sodium dehydroandroandrographolide succinate injection can contribute to the improvement of community acquired pneumonia in patients with peripheral blood T cell subpopulation structure,reduce the level of oxidative stress,improve the therapeutic effect,it is worthy of clinical application.

Objective To observe the change of peripheral blood Th17 cells and relationship between the severity and Th17 cells in patients with acute asthma.Methods We recruited patients with mild acute asthma(n=10) and severe acute asthma(n=10), and healthy volunteers(n=10). T-lymphocytes were collected from the peripheral blood mononuclear cells (PBMC). Flow cytometer (FCM) was used to detect the expression of peripheral blood Th17 cells. IL-17 levels in the peripheral blood were measured by enzyme-linked immunosorbentassay (ELISA).Results The rate of positive Th17 cells of peripheral blood in the severe acute asthma group was higher than that in the mild acute asthma group(P＜0.05) and the rate of positive Th17 cells of peripheral blood in healthy volunteer group were the lowest among all groups (P＜0.05, respectively). The level of IL-17 in the peripheral blood of patients with severe acute asthma increased significantly compared with that in patients with mild acute asthma and healthy volunteers (P＜0.05). The positive Th17 cells of peripheral blood in patients with acute asthma were positively correlated with the severity of acute asthma(r=0.869, P＜0.05).Conclusion The positive rate of Th17 cells in the peripheral blood increases in patients with acute asthma and has positive correlation with the severity of acute asthma.

OBJECTIVE To explore the absorption mechanism of thiophenorphine, and its effect on P-glycoprotein (P-gp) expression by using Caco-2 cell monolayer model. METHODSThe LC-MS-MS method was applied to determine thiophenorphine concentration in millicell system. The bi-directional permeability studies were performed to investigate the potential involvement of efflux carriers in the intestinal absorption. P-gp inhibition was studied by flow cytometry using calcein-AM as P-gp substrate.The expression of P-gp was evaluated using Western blotting. RESULTSThiophenorphine transport in Caco-2 cells was in time-dependent manner. Its average apparent permeability coefficient (P_(app)) was 2.338×10~(-6) cm·s~(-1). P_(app) was increased 2.8 folds by P-gp inhibitor ciclosporin A, and 2.3 folds by mulitdrug resistance-associated protein2 (MRP2) inhibitor MK571. The accumulation of calcein-AM and the expression of P-gp in Caco-2 cell line wasn't changed noticeably by thiophenorphine. CONCLUSION Thiophenorphine is a common substrate of P-gp and MRP2 and it shows normal transport in millicell system. The expression of P-gp doesn't induce by thiophenorphine.

Objective To explore the correlation of the indoor carbon monoxide concentration and chronic diseases by monitoring the indoor carbon monoxide concentration timely.Methods Collected the data of non-traumatic patients(n=80)from July 201 1 to January 2014,and assigned them into the experiment group with carbon monoxide concentration measured and the control group without measured.All the subjects were further divided into one group with complaint of carbon monoxide poisoning and the other one without.For patients exposed to high concentration of carbon monoxide,carboxyhemoglobin was also measured and APACHEⅡ was scaled,and the relationship between them was analyzed.The confirmation and misdiagnosis rate of carbon monoxide poison-ing were calculated.For the patients with acute exacerbation of chronic diseases like chronic cardiac failure,chronic obstructive pul-monary disease,cerebral infarction induced by carbon monoxide poisoning,BNP,CAT and NIHSS were documented on admission and during follow-up with removal of carbon monoxide exposure and compared respectively.Results The relationship between blood carboxyhemoglobin,APACHEⅡ scores on admission and indoor carbon monoxide concentration was linear,and obviously positive.Between the experiment group(n=40)and the control group(n=40),there was significant difference(P <0.05)in confirma-tion rate and misdiagnosis rate with 80.00% vs.55.00% and 6.25% vs.81.80% respectively.For the 54 patients with carbon monoxide poisoning diagnosed,the changes between before and after removal of carbon monoxide exposure of the CAT scores of chronic obstructive pulmonary disease and NIHSS score of CI disease and myoglobin,troponin I,creatine kinase isoenzyme,BNP for chronic cardiac failure were significantly different(P <0.01).Conclusion The indoor carbon monoxide concentration may indicate the severity of carbon monoxide poi-soning,which could increase the confirmation rate of carbon monoxide poisoning,and reduce the misdiagnosis rate.It is helpful to identify carbon monoxide exposure,the common inducing factor,so as to improve the patients′clinical symptoms.

Objective To establish a system of the screening, evaluation and intervention of congenital heart disease (CHD) in China. Methods All infants (16070) born in Changzhou Maternal and Child Health Hospital from May 1st 2011 to April 30th 2013 were screened for CHD. The infants with CHD were followed up till 1 year of age. Results One hundred and three infants were diagnosed with CHD, and the incidence rate was 0.641%. The top three CHD types in incidences were VSD (0.205%), PDA (0.174%) and ASD (0.10%), respectively. In these infants, 94 cases were followed-up and 9 cases were lost. The incidence of small gapped VSD, ASD and premature PDA were high. Some infants with serious CHD were subjected to surgery, and others were still followed up. Conclusions The incidence of CHD in Changzhou is comparable with that in the whole country. The follow-up can improve the life quality of CHD infants.