Objective To evaluate the efficacy of ambroxol on community acquired pneumonia (CAP) in elderly patients.Methods Totally 120 patients with CAP were selected and divided into 3 groups:low-dose group (patients received ambroxol 15 mg intravenously,3 times per day,n=40),conventional-dose group (patients received ambroxol 30 mg intravenously,3 times per day,n=40)and control group (patients received routine treatment including antibiotic therapy and oxygen inhalation,n=40).All patients were treated for 7 days.The levels of white blood cell (WBC),high sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were determined dynamically during the treatment.Results The markedly efficient rate,efficient rate and inefficient rate were 62.5％ (25/40),15.0％ (6/40) and 22.5％ (9/40) in low-dose group,82.5％ (33/40),15.0％ (6/40) and 2.5％ (1/40) in conventional-dose group,40％ (16/40),15.0％ (6/40) and 45.0％ (18/40) in control group,respectively.The total efficient rates were 77.5％,97.5％ and 55.0％ in low dose,conventional dose and control groups,respectively.The markedly efficient rate was higher in lowdose,conventional-dose groups than in control group (x2 =15.29,P＜0.05).There was a significant difference in markedly efficient rate between low dose and conventional-dose groups (x2 =4.01,P＜ 0.05).The total efficient rate was higher in low-dose,conventional-dose groups than in control group (x2 20.22,P＜0.05).There was a significant difference in total efficient rate between low dose and conventional-dose groups (x2=7.31,P＜0.05).Compared with before treatment,the levels of WBC,hs CRP and PCT were decreased in 3 groups after treatment (all P＜0.05).The levels of WBC,hsCRP and PCT were decreased more remarkably in low dose,conventional-dose groups than in control group (all P＜0.05).There was a significant difference in the decrease of WBC,hs-CRP and PCT levels between low-dose and conventional-dose groups (all P＜0.05).Conclusions Conventional dose ambroxol treatment (30 mg,iv,3 times/d) is an efficient therapy for community acquired pneumonia in elderly patients.

Objective To observe the effects ofShenkang bolt on the IL-10 and IL-6 of patients with continous ambulatory peritoneal dialysis (CAPD).MethodsA total of 60 patients with CAPD were divided into the control group (n=30) andShenkang bolt observation group (n=30). The control group was treated with convertional treatment of CAPD, low salt, low fat, low phosphorus and high quality diet. The observation group was treated withShenkang bolt based on control group treatment. The clinic effect was detected after treatment for 8 weeks. The serum creatinine was determinated by basic picric acid method, and blood urea nitrogen was determinated by urease test. The clinic and biochemical indicator of Scr, BUN, 24h urine volume, Kt/Vurea, RRF, and ultrafiltration volume were compared between the two groups. The IL-10 and IL-6 were detected by ELISA analysis.Results After treatment, IL-10 (19.56 ± 4.38μg/mlvs. 8.98 ± 2.05μg/ml,t=4.392,P<0.01) was significantly higher in observation group than that in control group, and IL-6 (21.82 ± 3.57μg/mlvs. 49.66 ± 5.26μg/ml,t=5.264,P<0.01) was significantly lower in observation group than that in control group. The RRF (7.86 ± 2.12vs. 5.31 ± 1.62;t=2.436, P=0.046) and ultrafiltration volume (421.37 ± 81.61 ml/dvs. 321.23 ± 71.94 ml/d;t=2.617, P=0.038) was significantly higher in observation group than those in control group. ConclusionShenkang bolt could help patients with CAPD balancethe immune, suppress inflammation and improve the RRF and ultrafiltration volume.

BACKGROUND:In the elderly patients with a variety of diseases, poor physical and compensatory ability results in a high demand for anesthesia during hip replacement and internal fixation. Lumbar epidural anesthesia with ropivacaine is the commonly used method of narcotic analgesics, but this method of anesthesia has been less studied in elderly hip replacement and internal fixation. OBJECTIVE: To investigate the effects of lumbar epidural anesthesia with ropivacaine in elderly hip replacement and internal fixation. METHODS: Data of fifty elderly patients with hip replacement implants and internal fixation, who were treated in the Department of Orthopedics, Affiliated Hospital of Xizang Minzu University from February 2014 to August 2015, were analyzed. 50 patients were randomly divided into continuous epidural anesthesia group and ropivacaine lumbar epidural anesthesia group, with 25 patients in each group. Anesthetic effect was compared. Self questionnaire on risk factors was used for non-conditional Logistic multivariate analysis between the two groups. RESULTS AND CONCLUSION: (1) Anesthetics onset time, the amount of local anesthesia, the use of trimetaphan camsilate agent number, complete block time, heart rate after anesthesia and complication rate were significantly less in the ropivacaine lumbar epidural anesthesia group than in the continuous epidural anesthesia group (P < 0.05). (2) The highest block level, Bromage score, mean arterial pressure after anesthesia and anesthesia satisfaction rate were significantly higher in the ropivacaine lumbar epidural anesthesia group than in the continuous epidural anesthesia group (P < 0.05). (3) Logistic multivariate analysis on postoperative cognitive dysfunction showed that postoperative cognitive dysfunction was strongly associated with age, education, complications, and hip arthroplasty (P < 0.05). (4) Results verified that lumbar epidural anesthesia with ropivacaine showed ideal effects in hip arthroplasty and internal fixation. Postoperative recovery was rapid, and it is safe and reliable.

dl-3-n-Butylphthalide can be applied in many areas of central nervous system diseases,such as cerebral ischemia,cerebral trauma,dysmnesia,convulsion,and so on.This paper reviewed the effect and mechanism of it.

China ; Environmental Monitoring ; legislation & jurisprudence ; Environmental Pollutants ; Organic Chemicals

Objective To investigate the distribution and effect of class Ⅰ integron in 40 strains of clinical multi-resistant Enterobacter cloacae. Methods Kirby-Bauer method was used to analyze the drug resistance of 40 strains of multi-resistant Enterobacter cloacae and the drug resistance gene was analyzed by polymerase chain reaction (PCR). Results 28 strains (70.0%) of 40 clinical isolates were observed to contain class Ⅰ integron. Drug resistance test showed their resistance rate to 10 kind of an-tibaeterials as follow: 7.5% to imipenem, 5.0% to meropenem, 75.0% to piperacillin-tazobactam,55.0% to amikacin, 12.5% to cefepime, 52.5% to ceftazidime, 55.0% to cefotaxime, 90.0% to ceftriaxone;81.8% to ticarcillin-clavutanic acid, and 85.0% to ciprofloxacin. Conclusion This study shows that the resistance situation of Enterobacter cloacae isolates is very serious, and class Ⅰ integron may play an important role in the muhidrug resistant mechanism.

[Objective]To investigate the clinical value of computed radiography(CR),computed tomography(CT)and magnetic resonance imaging(MRI)in spinal tuberculosis.[Method]Forty-one patients with histologically confirmed spinal tuberculosis underwant imaging examinations.Forty-one patients were performed CR,22 CT and 31 MRI.[Result]CR of 38 patients clearly revealed bone changes and narrowed or disappeared disk space.CR of 30 patients well showed the abnormal soft tissue.CT scan of 22 patients clearly depicted calcification and no abnormal was found in pedicles in all the 22 CT scans.CT scan of 21 patients revealed bone changes of vertebral bodies and CT scan of 20 patients showed abnormal soft tissue.The soft tissue was involved in all 31 patients with spinal tuberculosis.Diskspaces were involved in 29 cases and the pedicles were normal in all 31 case.The lesions showed hypointense in T1 scan primarily,hyperintense in T2 scan primarily.[Conclusion]CR is the first imaging approach for spinal tuberculosis.CT well reveal the extent and minute calcification.The extent,abnormal soft-tissue and abnormal disk space are more dramatically demonstrated on MRI imaging.CR,in addition to CT and MRI,is helpful in diagnosis of spinaltubereuinsis.

AIM:To compare the influence of anterior chamber maintainer and viscoelastic agent on corneal astigmatism and endothelial cells after phacoemulsification.METHODS:Totally 70 patients(70 eyes) of cataract from April 2013 to April 2015 were randomly divided into the study group and the control group, with 35 cases in each group.The study group were treated with anterior chamber maintainer during phacoemulsification with support system approach, and the control group were treated with phacoemulsification under viscoelastic agent.RESULTS:The age (t=0.215, P=0.831), the density of corneal endothelial cells (t=-0.352, P=0.726) and corneal luminosity (t=-0.162, P=0.872) of two groups had no significant difference before surgery;there were no significant difference in preoperative visual acuity (t=0.463, P=0.599) and visual acuity (t=1.616, P=0.124) at 1mo after operation.And patients in the study group (t=-21.129, P<0.01) and the control group (t=-12.780, P<0.01) before surgery and 1mo postoperative when compared with the naked eye eyesight showed significant difference.The visual acuity after operations improved significantly.There were significant differences of corneal endothelial cells density (t=8.489, P< 0.01) and corneal astigmatism (t=-2.032, P=0.046) in the study group before surgery and 1mo after surgery;corneal endothelial cell density (t=8.999, P<0.01) and corneal astigmatism (t=-2.167, P=0.034) in the control group before surgery and 1mo after surgery also had significant differences.There was no significant difference in the rate of corneal endothelial cell loss between the two groups (t=0.410, P=0.683).CONCLUSION:Compared with viscoelastic agent, anterior chamber maintainer during phacoemulsification in patients with cataract won't increase the damage of postoperative surgically induced astigmatism and corneal endothelial cells, which mean the method of anterior chamber maintainer during phacoemulsification in the treatment of cataract is safe and effective.

Objective To evaluate the efficacy and safety of high-dose ambroxol in treating acute exacerbations in chronic obstructive pulmonary disease (AECOPD).Methods The trial design was random,open,and parallel control.126 patients with AECOPD were involved.High-dose group received ambroxol 150 mg 3 times per day for 7 days (n=46),while conventional-dose group given ambroxol 30 mg 3 times per day for 7 days (n=40) and control group was given a routine treatment (antibiotic therapy,oxygen inhalation and bronchodilators) (n=40).Results The effective rates of high-dose group and conventional-dose group (95.6 ％,77.5 ％) were significantly higher compared with control group (55.0％) (x2 =19.81,4.53,both P＜0.05).The average duration of hospitalization was significantly lower in high-dose group (10.78 ±0.95)d and conventional-dose group (11.75±0.84)d comparing with control group (13.15±0.89)d (q=11.88,7.24,both P＜0.05).The clinical efficacy in high dose group was much better.Conclusions High-dose ambroxol is a safe and efficient therapy in the treatment of acute exacerbations in chronic obstructive pulmonary disease.

OBJECTIVE To investigate the protective mechanism of recombinant bactericidal permeability-increasing protein 21(rBPI21) in rat endotoxemia.METHODS The different dosage of rBPI21 in endotoxemia rats was injected and the changes in lipopolysaccharide(LPS), lipopolysaccharide binding protein(LBP) and tumor necrosis factor ?(TNF?) contents in blood of different group rats were continuously observed.RESULTS At 6 and 12 hours,the levels of LPS in rBPI21 treatment 1 group(rBPI21 dosage 0.625 mg/kg) were significantly lower than those in endotoxin group at the same time.Serum LBP and TNF? in rBPI21 treatment 1 group were both lower than those in endotoxin group at any time point.Compared with the endotoxin group,the levels of LPS,LBP,and TNF? in rBPI21 treatment 2,3 and 4 groups(rBPI21 dosage 1.25 mg/kg,2.5mg/kg,and 5.0mg/kg,respectively) markedly dropped at any time points,the survival rates were increased from 16.7%(endotoxin group) to 58.3%,91.7% and 100%(rBPI21 treatment 2,3,and 4 groups) individually.CONCLUSIONS The protection of rBPI21 in endotoxemia rats is primarily achieved through neutralizing LPS,decreasing LPS activity in vivo and inhibiting LBP and TNF-? synthesis.