After more than 30 years of development, noninvasive positive pressure ventilation (NPPV) has become one of the main treatments of sleep-disordered breathing (SDB) in the world. It is the wide application of this technology that makes breakthrough in SDB treatment, and has given rise to a new interdisciplinary area sleep medicine. In China, sleep medicine started in late of 1980's, in recent years, with the development of economy and the improvement of recognization, the application of NPPV in Chinese market has become one of the fastest growing in the world. NPPV technology also extends gradually to the treatments of patients with respiratory failure due to different causes, such as severe acute respiratory syndrome and COPD.
China ; Humans ; Positive-Pressure Respiration ; Respiratory Insufficiency ; Sleep Apnea Syndromes ; therapy ; Sleep Medicine Specialty ; trends

10.3969/j.issn.1008-9691.2013.03.016

Objective To evaluate the predictive value of diffusion weighted imaging ( DWI) for progres-sion free survival(PFS)in patients with cervix cancer after neoadjuvant chemotherapy (NACT).Methods Thirty two consecutive patients with pathologically confirmed cervical cancer underwent MRI including DWI before and after NACT.Pathologic results and MR images were reviewed .Univariate analysis was applied by Kaplan -Meier method.The Cox proportional hazard model was used to evaluate prognostic variables for multivariate analysis .Re-ceiver operating characteristic ( ROC) curves were used to find optimal cutoff values of independent prognostic fac -tors for disease progression.Results Of 32 patients,10 had disease progression during follow -up period.In uni-variate analysis,FIGO stage,tumor size,the depth of tumor invasion,lymph node metastasis and ADC changes be-tween before and after neoadjuvant chemotherapy (ΔADC) were significantly associated with the disease progres-sion.In multivariate analysis , FIGO stage and ΔADC were the independent prognostic factors for PFS .Optimal cutoff values that determined by ROC curves analyses were FIGO stage ⅡandΔADC 0.31.Area under the ROC curve(AUC)of FIGO stage and ΔADC were 0.841(sensitivity 90.0%,specificity 68.2%)and 0.864(sensitivity 80.0%,specificity 81.8%),respectively.Conclusion In patients with cervix cancer after NACT ,FIGO stage andΔADC are significant predictive values for PFS .

After summing up the experience of recent years' clinic teaching, ICU department in Fangcun Branch of Second Clinical Medical College of Guangzhou University of TCM comes to a conclusion that, the clinical teaching of ICU should pay attention to and ensure effective implementation of beginning educationg. And following the PDCA method (Plan, Do, Check & Act) will make the work orderly, normative and controllable and meanwhile raise the students' observing and analysis ability as well as their operation and doctor-patient communication ability. In this way we can mostly enhance the effect of teaching.

ObjectiveTo observe the expressions of Caspase-9,Caspase-3, cytochrome C and their relationships, and investigate apoptotic mechanisms in hippocampus of post-traumatic stress disorder(PTSD) rats. Methods Sixty male Wistar rats were used in the present study. The single-prolonged stress (SPS)-method was used to set up the rat PTSD models. There were six groups:after SPS 1 day,4 days,7 days,14 days,28 days groups and control group. The expressions of caspase-9, Caspase-3 and Cytochrome C proteins were detected with immunohistochemistry, immunofluorescence and Western blotting. Results Immunohistochemical and immunofluorescent results showed that the expression of cytochrome C peaked at 4 days and maintained higher level at 7days after SPS. Expressions of Caspase-9 and Caspase-3 were increased and peaked at 7days after SPS. Western blotting results showed that compared with control group, cytochrome C protein was up-regulated and peaked at 4 days after SPS in the cytosol. Compared with the control group, cytochrome C tended to decrease in mitochondrial fractions. The activated form of Caspase-9 and caspase-3 were not detected in control group. They were present in model groups. Cleaved- caspase-9 and cleaved-caspase-3 peaked at 7 days after SPS, and then gradually decreased at 14 days. Conclusion The neuronal apoptosis in hippocampus of PTSD rats may be one of the causes inducing hippocampus atrophy. Mitochondrial apoptotic pathway is involved in apoptosis in the hippocampus of PTSD rats.

Objective To investigate expression changes of nuclear receptors-glucocorticoid receptors (GR) in the locus ceruleus neurons of posttraumatic stress disorder(PTSD)like rats. Methods Sixty adult healthy male Wistar rats were enrolled in the experiment. PTSD-like rat model was established by single prolonged stress (SPS). There was no SPS stimulation in the control group and the rats of the other five groups were undisturbedly raised for 24 hours, 4 days,7 days,14 days and 28 days respectively after SPS stimulation.The expressions of glucocorticoid receptors in the locus ceruleus nucleus of all groups were detected with Nissl staining, immunohistochemistry,Western blotting and PCR, and image analysis and statistical analysis were performed. Results GR was distributed in the nucleus of coeruleus neurons, GR expression was showed after 24 hours, 4 days, 7 days treatment and gradually increased, restorative downregulation was seen after 14 days and 28 days, but still high(P<0.05). Conclusion After SPS, the GR locus ceruleus temporarily increased and then lowered, suggesting that PTSD rat locus coeruleus neurons in nuclear receptor-GR expression changes may directly involve in the continuing spirit of PTSD symptoms occurred in the development process.

Objective To observe the expression of cytochrome C (Cyt C)and apoptosis-related gene Bax in hippocampus of posttraumatic stress disorder(PTSD)rats in order to investigate their effects and relationships. Methods Sixty male Wistar rats were used in the present study. The single-prolonged stress(SPS)-method was carried out to set up the rat PTSD models. There were six groups:after SPS 1,4,7,14,28 days groups and control group. The expression of Cyt C and Bax proteins were detected with immunohistochemistry, double immunofluorescence, confocal laser scanning microscopy and Western blotting. Results The expression of Cyt C peaked at 4 days and maintained higher level at 7 days after SPS. At 7 days after SPS, strong immunoreactivity of Bax was noticed,At 14 days after SPS, the expression of Bax was down-regulated and then gradually decreased. Conclusion Bax is upregulated and promotes the releasing of Cyt C. And the releasing of Cyt C may be one of mechanisms of inducing apoptosis in the hippocampus of PTSD rats.

The application and development of catalytic fluorimetry in recent years were reviewed with 103 references. The new technique and application of catalytic fluorimetric methods, such as the determination of catalyst and activator, multicomponent determination, enzyme catalysis, the effect of micelle in multicomponent determination and enzyme catalysis, the combination with flow-injection or stopped-flow tachniques and laser induced fluorimetry, time resolved fluorimetry, bioreactor control, biosensor, medicine assay, bioanalysis were mainly discussed. Future study was envisioned

Objective To study whether stilnox intervention could prove the prognosis for subjective tinnitus patients combined with sleep disorders.Methods By random and double-blind method,68 tinnitus patients with sleep disorders were randomly divided into the treatment group and control group,with 34 cases in each group.The patients in the control group received ginaton and methycobal oral administration.On the basis of this,the patients in the treatment group received Stilnox oral administration before sleep.All objects of study were evaluated using Tinnitus handicap inventory (THI)and Pittsburgh sleep quality index (PSQI)two weeks before and weeks after treatment.Results The tinnitus disability in the treatment group showed statistical differences before and after treatment (t=8.810,<0.05).The levels of sleep disorders in the treatment group showed statistical differences after treatment (t=20.446,<0.05).The tinnitus disability in the control group showed statistical differences after treatment(t=6.900,<0.05).The sleep disorders in the control group showed statistical differences before and af-ter treatment(t=4.631,<0.05).The tinnitus disability (t=2.313,<0.05)and sleep disorders(t=7.906,<0. 05)after treatment showed statistical differences between the treatment group and control group.Conclusion Stil-nox intervention therapy could improve the prognosis of subjective tinnitus patients with sleep disorders.

[ABSTRACT]OBJECTIVETo assess the efficacy of postauricular injection of shuxuening combined with lidocaine in treating intermediate and high-frequency sudden hearing loss.METHODS48 patients with intermediate and high-frequency sudden hearing loss were randomly divided into postaurical injection group (n=24) and control group (n=24). The control group was given hormone, microcirculation improvement, nutrition of nerve and other conventional treatment. The postauricular injection group received 3 doses of postauricular inject of 0.5ml shuxuening and 0.3ml lidocaine tertian injection in addition to conventional treatments.RESULTSTwo weeks after administration, the total effective rates of postauricular injection group 87.5%were significantly higher than that of the control group 62.5%. Pure tone average improved (20.74±15.19)dB on average in the postauricular group, and (12.44±9.12)dB in the control group. The difference was statistically significant (P<0.05). CONCLUSIONPostauricular injection of shuxuening combined with lidocaine treatment for intermediate and high-frequency sudden hearing loss has better curative effect than that of the conventional treatment.