OBJECTIVE:To investigate the application of antibacterials in patients with chronic obstructive pulmonary disease(COPD)in our hospital.METHODS:A retrospective analysis was performed on 77 COPD inpatients with respect to the varieties of antibiotics,DDDs,drug costs,routes of administration,medication duration,combined use of antibiotics,therapeutic outcome,bacterial culture and susceptibility test,adverse drug reactions(ADR)and irrational drug use etc.RESULTS:100% of the patients received antibacterials.Topping the first five places on the DDDs list were levofloxacin,cefuroxime,amoxicillin/clavulanate potassium,ceftazidime and azithromycin.The combined use of two kinds of antibiotics accounted for 77.65% versus 2.35% of three kinds concomitantly.CONCLUSION:The use of antibacterials in COPD patients in our hospital is basically rational;however,the indications of antibacterials for COPD patients should be followed strictly toachieve rational and standard drug use.

Objective To survey cervical myoelectric signals during craniocervical flexion, neutral and extension postures, and to explore the evidence that proper head position can alleviate cervical muscle fatigue in a lateral recumbent position. Methods Surface electromyography (sEMG) signals were detected from the sternocleidomastoid, upper trapezius and erector spinae muscles of 30 young subjects bilaterally during craniocervical flexion,neutral and extension postures in the left lateral recumbent position. The integrated trace area (IEMG) and median frequency (MF) were estimated. Results The average IEMG of the sternocleidomastoid muscles was significantly lower in flexion than in extension bilaterally. The average IEMG of the erector spinae muscles was lower in extension than in flexion bilaterally, and the difference was again significant. The IEMGs of the upper trapezius muscle showed no significant difference on average in the three postures bilaterally. There was no significant MF difference in any of the muscles. Conclusions The muscles in the cervical back were less activated during craniocervical extension in a lateral recumbent position. A little cranicocervical extension is optimal while resting in a lateral recumbent position.

Objective To establish blood purification system for rats and provide a safe and reliable experimental platform for further research of blood purification. Methods The right carotid artery and the contralateral jugular vein of adult male Sprague?Dawley rats were cannulated to creat vascular access for blood purification, by which continuous arteriovenous hemofiltration blood purification system was established. Blood flow, substitution fluid flow and ultrafiltration rate were regulated by rotary mini?pumps. Blood purification therapy continued for 4 hours on the basis of maintained anesthesia and effective anticoagulation. The safety of continuous arteriovenous hemofiltration blood purification systems was evaluated by comparing the arterial blood gas, electrolyte indexes and blood glucose during the blood purification therapy. Closely monitoring the vital signs of rats, such as blood pressure and heart rate, and observing whether there were any side effects, such as massive haemorrhage, thrombogenesis and gas embolism in the therapeutic process. Results There were no obvious changes of arterial blood gas, electrolyte indexes and blood glucose during the blood purification therapy (P>0.05). The vital signs did not fluctuate acutely before and after the blood purification therapy (P>0.05). The incidence rate of side effects was very low. Conclusions
Continuous arteriovenous hemofiltration blood purification system had no obvious adverse effects on healthy rats. Our blood purification system for rats appears to be safe and reliable.

AIM:To observe the influence of Lycium barbarum polysaccharide (LBP) on the PI3K/Akt/eNOS signaling pathways in ovariectomized rat myocardium .METHODS:Female SD rats (n=30) were divided into sham oper-ation group , ovariectomized group , progynova group , high-dose LBP group and low-dose LBP group .The serum levels of estradiol, lactate dehydrogenase (LDH) and creatine kinase (CK) were measured by ELISA.The myocardial contents of H2 S and oxidative stress injury-related indicators were also detected .The morphological changes of the myocardium were observed with HE staining.The expression of eNOS and PI3K/Akt pathway-related proteins in the myocardium was deter-mined by Western blot .RESULTS: Compared with sham operation group , the serum level of estradiol , the content of H2 S, the activity of GSH-Px, and the expression of eNOS and PI3K/Akt pathway-related proteins in the myocardium in ovariectomized group were all decreased , and the levels of ROS and MDA in the myocardium were increased (P<0.05). The serum levels of LDH and CK were also increased .The arrangement of the myocardial cells was disordered , and the in-tercellular space was also increased in the ovariectomized group .Compared with ovariectomized group , the serum level of estradiol, the myocardial levels of H2S and GSH-Px, and the protein levels of eNOS and phosphorylated Akt were all in-creased in high dose group, while the levels of ROS and MDA in the myocardium were decreased (P<0.05).The serum levels of LDH and CK were also decreased .The morphological changes of the rat myocardium were improved in high dose group.CONCLUSION: LBP prevents and treats postmenopausal cardiovascular lesions through regulating PI 3K/Akt/eNOS signaling pathways in ovariectomized rats .

ObjectiveTo understand the characteristics of mutations in BCR-ABL1 kinase domain mutation,these chronic myeloid leukemia (CML) and Ph positive acute lymphoblastic leukemia (ALL)patients who got imatinib treatment had poor effect.MethodsTotally 177 CML patients and 33 Ph( + )ALL patients were selected at Beijing Dao-Pei Hospital from Sep.2007 to Dec.2010.All of them were Chinese patients.Totally 243 bone marrow or peripheral blood specimens were collected from the patients,who had early effect,then resistance emergenced,or for more than 3 months of poor efficacy.Extracted total RNA from the specimens' nuclear cells,reversed transcription to cDNA.Amplified the whole span of BCRABL1 fusion kinase gene by nest PCR (from 242 to 493 amino acid coding sequence),used the type AB3130XL gene sequencing instrument determinate the gene sequence of ABL1 kinase region and then used the Variant Reporter V1.0 software to analyze the results of gene mutations.ResultsThirty-two kinds of different mutations were detected of ABL1 gene mutations,accounting for 34.2％ (83/243 cases).Among them,the T315I was 12％ (10/83),mutation rate was the highest,followed by Y253H was 11％ (9/83),G250E was 7％ (6/83),E255K was 7％ (6/83),M351T was 6％ (5/83),E459K was 5％ (4/83) ;Q252H,D276G,F317L,E355G,F359V,H396R were all 4％ (3/83).Three cases of insertion mutations were found,including 2 cases of 357-358insk,1 case of V304RfsX17.Seven patients had found existence two or more point mutations.The multiple drug resistance mutations might exist in the same leukemia clone.The same individual was not only contain common resistance mutations,but also rare point mutations,insertion mutations.The mutations might be lead to loss of kinase activity.ConclusionsUnder the imatinib drugs pressure,the ABL1 gene mutation in leukemia cells appears randomly,and results in different resistant clones.Different resistant clones can coexist in the same patients in vivo; resistant clones not only contain point mutations,but also contain inserted deletion mutations.

Objective:To investigate the expressions and clinical significances of SMO , STAT3 and MMP-9 in triple negative breast cancer ( TNBC) .Methods:The expressions of SMO , STAT3 and MMP-9 were immunohistochemically detected in 33 cases of TNBC, 30 cases of mammary hyperplasia and 18 cases of normal breast tissue , and the relationships among SMO , STAT3 and MMP-9 and clinicopathological parameters and prognosis of TNBC patients were analyzed .Results:In TNBC and mammary hyperplasia tissue , the positive expression rates of SMO were 90.9%and 60.0%,the positive expression rates of STAT3 were 96.9% and 73.3%, the positive expression rates of MMP-9 were 90.9% and 36.7%, respectively, however, expressions of them were completely absent in normal breast tissue .The significant correlations were observed between expressions of SMO , STAT3 and MMP-9 in TNBC, mammary hyperplasia and normal breast tissue (P<0.05).The expression of SMO and STAT3 was correlated with superior histologic grade and tumor stage .The expression of MMP-9 was correlated with metastasis of lymph node .The positive correlation was manifested between SMO and STAT3(r=0.361,P<0.05),between SMO and MMP-9 (r=0.633,P<0.01),between MMP-9 and STAT3 (r=0.803,P<0.01) in TNBC.The survival time of TNBC patients was correlated with SMO expression and pTNM (P<0.05).Conclusion:SMO, STAT3 and MMP-9 may play important roles in development of TNBC and may be an important therapeutic target in TNBC .

Objective To explore the relationship of phosphatase and tensin homology (PTEN) deleted on chromosome ten with the apoptosis of hepatic stellate cells (HSCs) in liver tissues of rats with hepatic fibrosis induced by bile stagnation.Methods Fifty adult male SD rats were randomly divided into model group (n=40) and sham operation group (n=10).The model of hepatic fibrosis was reproduced in model group by common bile duct ligation (BDL).Liver tissue of rats in model group (1,2,3 and 4 weeks after BDL) and sham operation group were obtained.PTEN expression in liver tissue was detected by immunohistochemistry.Apoptosis of HSC was determined by dual staining of terminal deoxynucleotidy transferase UTP-nick end labeling (TUNEL) and ?-SMA immunohistochemistry.Results Only a few apoptotic HSCs were found in normal livers.With the development of liver fibrosis,the expression of PTEN decreased gradually (P

Objective To explore the effect of giving sedatives according to the circadian rhythm in prevention of occurrence of delirium and the prognosis of patients undergoing mechanical ventilation in intensive care unit (ICU). Methods A prospective double-blinded randomized controlled trial (RCT) was conducted. The patients admitted to Department of Critical Care Medicine of the Second Hospital of Lanzhou University from July 2014 to February 2015, undergoing invasive mechanical ventilation over 12 hours were enrolled. All the patients were given fentanyl for analgesia, and they were randomly divided into simulated circadian clock group (study group, n = 35) and non-simulated circadian clock group (control group, n = 35). The patients in each group were subdivided into three subgroups according to the kinds of sedative drugs, namely dexmedetomidine group (n = 8), propofol group (n = 14), and dexmedetomidine combined with propofol group (combination group, n = 13). Visual analogue scale (VAS) standard and Richmond agitation-sedation scale (RASS) were used to control the analgesic and to quantify the depth of sedation by titrating the dose of sedative drugs, the simulated circadian clock was set to control the RASS score at 0-1 during the day, and -1 to -2 at night in study group. The RASS score in the control group was set at -1 to -2 day and night. The urine 6-hydroxy acid melatonin (aMT6s) levels at different time points in the first diurnal rhythm (06:00, 12:00, 18:00, 24:00) were determined by enzyme linked immunosorbent assay (ELISA). The incidence of delirium, severe hypotension, severe bradycardia and other adverse reactions, duration of mechanical ventilation and the time of extubation, length of ICU stay, amount of sedative and analgesic drugs used were recorded. The correlation between delirium and other indexes was analyzed by using Spearman correlation analysis. Results ① There were no significant differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score among groups. ② Urine aMT6s levels did not show circadian rhythm in both groups, aMT6s level at 06:00 in study group showed an increasing tendency as compared with the control group, but the difference was not statistically significant. ③ Compared with the control group, the incidence of delirium was significantly lowered in the study group (14.3% vs. 37.1%, P = 0.029), but no significant differences were found in the incidence of severe hypotension or severe bradycardia (20.0% vs. 25.7%, 11.4% vs. 20.0%, both P > 0.05). In simulated circadian clock group, the incidence of delirium in dexmedetomidine group was significantly lower than that of the propofol group (6.3% vs. 32.1%, P < 0.05). ④ Compared with control group with the same sedative, the duration of mechanical ventilation, extubation time, length of ICU stay were significantly shortened, and the dosage of sedative drugs used was reduced in study group (all P < 0.05). In simulated circadian clock group, the duration of mechanical ventilation in dexmedetomidine group was significantly shorter than that of propofol group and combination group (hours: 75.75±26.78 vs. 102.00±26.31 and 100.31±25.38, both P < 0.05), and the length of ICU stay was significantly shorter than that of propofol group (days: 5.75±1.04 vs. 7.00±1.52, P < 0.05). ⑤ The occurrence of delirium was positively correlated with duration of mechanical ventilation (r = 0.705), extubation time (r = 0.704), length of ICU stay (r = 0.666, all P = 0.000), and no correlation was found between the occurrence of delirium and aMT6s level at 06:00, 12:00, 18:00, and 24:00 (r = -0.135, r = 0.163, r = 0.269, r = -0.077, all P > 0.05). Conclusions Administration of sedatives according to simulating circadian time could decrease the duration of mechanical ventilation, extubation time, and the length of ICU stay, decrease the dosage of sedative drugs, and reduce the incidence of delirium. Dexmedetomidine could reduce the incidence of delirium, and improve the prognosis of patients. Trial registration Registration of clinical trials in China, ChiCTR-IPR-15006644.

ObjectiveTo assess the effects of constraint-induced movement therapy(CIMT) on sub-acute stroke patients with upper extremity motor dysfunction.Methods63 patients with hemiplegia after stroke were divided into two groups: control group(31 cases) and CIMT group(32 casese). The two groups received the regular rehabilitation training for 14 d. Then the control group went on the the regular rehabilitation training, while the CIMT group received CIMT for 14 d. All patients were assessed by the Action Research Arm Test(ARAT) and Fugl-Meyer(FMA) on the first day, the 15th day and the 30th day after the treatment.ResultsARAT score and FMA scores were higher in CIMT group than in the control group 30 d after the treatment and in CIMT group 15 days after the treatment(P<0.001).ConclusionCIMT is more effective to improve the upper limb motor function of the sub-acute stroke patients than the regular rehabilitation training.

Objective:To explore the distribution characteristics of brachial-ankle pulse wave velocity (BaPWV) in adolescents.Methods:Cross sectional survey research.A total of 1 607 adolescents aged 12-17 years from 5 middle schools in the Haidian District, Beijing from June 2020 to May 2021 were enrolled for measuring their blood pressure, weight, height and the body mass index (BMI), including 782 males and 825 females.BaPWV was measured using an arteriosclerosis detector.They were divided by the age, sex and obesity.Differences of measurement data among multiple groups were compared by one-way ANOVA, followed by the LSD test, and those between groups were compared by the two-sample t-test.The correlation between BaPWV and other indexes was assessed by the Pearson correlation analysis. Results:The median level of BaPWV in adolescents aged 12-17 years increased with age, which was 982.50 cm/s in adolescents aged 12 years, and maximum 1 113.50 cm/s those aged 17 years.BaPWV in adolescents aged 12-17 years was positively correlated with age ( r=0.936, P=0.006). Subgrouped by the sex, the median BaPWV of male and female adolescents aged 12 years was 962.25 cm/s and 997.50 cm/s, respectively, which reached 1 122.50 cm/s and 1 096.00 cm/s in those aged 17 years, respectively.BaPWV of male and female adolescents was positively correlated with the age ( r=0.903, P=0.014; r=0.945, P=0.004). In male adolescents, BaPWV was positively correlated the systolic and diastolic blood pressure, age, weight, height, BMI( r=0.308, P<0.001; r=0.289, P<0.001; r=0.478, P<0.001; r=0.190, P<0.001; r=0.315, P<0.001; r=0.109, P=0.002). In female adolescents, BaPWV also was positively correlated the systolic and diastolic blood pressure, age, weight, height, BMI( r=0.340, P<0.001; r=0.285, P<0.001; r=0.379, P<0.001; r=0.115, P=0.001; r=0.170, P=0.001; r=0.097, P=0.014). In the overall population, BaPWV was statistically significant between the obese and normal groups ( t=-3.428, P=0.001). No significant difference in BaPWV between male and female adolescents aged 12-13 years was identified ( t=0.123, P=0.902 ), but it was significantly lower in female adolescents aged 14-15 years and 16-17 years than those of age-matched males( t=2.315, P=0.021; t=2.152, P=0.032). Conclusions:The median BaPWV level in adolescents aged 12-17 years, increases with the age.Systolic blood pressure, diastolic blood pressure, body weight, BMI, age and height are positively correlated with BaPWV in adolescents.Obesity can increase the stiffness of blood vessels, which is influenced by the sex.