Objective To investigate the application and nursing care of bronchoalveolar lavage (BAL)by fiberoptic bronchoscopy in patients with mechanical ventilation. Methods 64 patients with mechanical ventilation in RICU were randomly divided into the control group and the observation group with 32 patients in each group. The patients in both groups were accepted anti-infection, atomization inhalation and other supportive treatments. The patients in the observation group were treated with BAL, and the patients in the control group accepted routine treatment. The therapeutic effects in the two groups were evaluated and compared. Results There was significant difference in the recovery rate and effective rate, the blood gas analysis compared with the control group was significantly improved, the time of pulmonary infection control window, mechanical ventilation, length of stay were shorter than the control group. The case number to remove ventilator successfully, organs failure and hospital mortality were less than the control group. Conclusions Fiberoptic bronchoscopy with BAL treatment could be safety and efficacy for patients with mechanical ventilation. Nursing intervention plays an important role and a good therapeutic effect for improving achievement ratio of BAL.

Multi-target drugs can simultaneously adjust multiple links of the disease network. Despite the higher efficacy and lower toxicity caused by single targets, multi-target drugs become ideal drugs for treating complicated diseases as well the main direction of drug R & D. By virtue of their structural diversity, higher multi-target activity and lower toxicity, natural products become an important source for developing multi-target drugs. Computer-aided drug design (CADD) is a commonly used multi-target drug R&D method, which mainly includes virtual screening and pharmacophore design. In this paper, the authors made a systematical analysis and discussed the prospects and advantages of various methods for multi-target drug R&D with natural products.
Biological Products ; chemical synthesis ; pharmacology ; Biomedical Research ; instrumentation ; Computer-Aided Design ; Drug Design ; Humans ; Molecular Targeted Therapy

OBJECTIVE:To study the volatile constituents of the compound extract from Folium Perillae,Pericarpium Citri and Herb Schizonepetae in Siji Ganmao tablet by supercritical CO2 fluid extraction (SFE-CO2). METHODS:Supercritical CO2 ex-traction technology was used to extract the volatile constituents of 3 medical material in Siji Ganmao tablet. The chemical constitu-ents of the compound extract from 3 medicinal materials were analyzed by GC-MS. RESULTS:The extracting rate of SFE-CO2 was 2.21%,21 compounds in the compound extract were separated and 16 compounds were identified with the major components of si-nensetin(36.56%)and linolic acid(19.52%). The extracting rate of water steam distillation(SD)was 1.035%,51 compounds in the compound extract were separated and 32 compounds were identified with the major components of D-limonene(62.40%) and thujone(15.49%). CONCLUSIONS:The volatile constituents of F. perillae,P. cCitri and H. Schizonepetae can be compound ex-tracted by SFE-CO2,however,it is different from the constituents of the compound volatile oil by SD.

To study the quantitative structure-activity relationship (QSAR) between the stuctures of 29 flavonoids and the inhibitory activity of their multidrug resistance-associated protein (MRP) 1 and 2 by using the comparative molecular similarity index analysis (CoMSIA). By studying the impact of the combination of different molecular force fields, researchers obtained the molecular force fields that played an important role in inhibiting the activity of MRP1 and MRP2, built the optimized QSAR model, and discussed the structural modification method for flavonoids' multidrug resistance-associated protein inhibitor. The results of the study could not only provide the guidance for new drug R&D, but also help partially discuss the synergy mechanism between MRP1 and MRP2 receptors and traditional Chinese medicines containing flavonoids.
Drugs, Chinese Herbal ; chemistry ; pharmacology ; Flavonoids ; chemistry ; pharmacology ; Humans ; Models, Molecular ; Multidrug Resistance-Associated Proteins ; antagonists & inhibitors ; chemistry ; Quantitative Structure-Activity Relationship

Objective To learn the current anesthesiologists deployment at the hospital,and to figure out how to measure anesthesiologists deployment.Methods Existing data and expert consultation were used to obtain various indicators,and the current anesthesiologists deployment was analyzed,calculating with the formula the needed number of anesthesiologists.Results Despite the rising demand and resource utilization,anesthesiologists were found in obvious shortage at the hospital.The number of anesthesiologists needed was calculated as 101.4,with a vacancy of 11.4.Conclusion The national health authorities were recommended to revise the standard of anesthesiologists deployment at hospitals.

Objective To analyze the clinical outcomes of patients treated with in vitro fertilization and embryo transfer (IVF-ET) and influence factors of pregnancy rate. Methods We retrospectively analyzed the clinical data of 12 491 cycles, including 6832 fresh IVF/intracytoplast single sperm injection (ICSI) cycles and 5659 frozen embryo transfer (FET) cycles from 2005 to 2007. Results The clinical pregnancy rate per cycle was 32. 99% (2254/6832)in fresh embryo transfer program, and the live birth rate was 25.75% (1394/5413); the early pregnant loss rate was 9. 36% (211/2254), and the prenatal defect rate was 1.45% (25/1722). Through analysis of these patients' basic data, we found that the patients' age, causes for infertility, egg retrieval and cycle number affected the pregnancy rate. Using logistic regression method, we found that patients′ age was the most important factor affecting pregnancy outcome. In FET cycles, the clinical pregnancy rate was 38.08% (2155/5659), significantly higher than fresh embryo transfer cycles. Conclusions IVF-ET treatment is a safe and effective method for infertility couples. However, the female age and poor ovarian response are the main factors affecting pregnancy rate. Thawed embryo transfer can increase the accumulated pregnancy rate effectively.

Objective Acute type A aortic dissection associated pregnancy severely threatens the lives of both the mother and her ferus.We retrospectively reviewed our clinical experience with this life-threatening condition in six cases.Methods Between January 2007 and February 2012,6 women with acute type A aotic dissection associated pregnancy were treated by our group,with an average of 3 1 years (range 24 -37 weeks)and a mean gestation weeks of 24.5 (range,12 -38 weeks ).The etiology was Marfan syndrome in 4 cases and gestational hypertension in 2.The pathology was the modified Stanford type A3S in I case,A2C in 2 and A3C in 3.- Five patients were treated surgically and 1 medically.Surgical operations were performed under hypothermic cardiopulmonary bypass or deep hypothermic circulatory arrest,including Bentall procedure in 1case,Bentall + Sun's procedure in 2,ascending aortic replacement + Sun's procedure in 2.Results The woman treated medically and her fetus died from aortic rupture 9 days after admission.The cardiopulmonary bypass and cross clamp time and circulatory arrest time averaged 167 rninites(range,75 -210 minites) and 98 minites(range,83 - 145 minites) and 23.5minites(range,19 -27 minutes),respectively.Five patients treaed surgically survived the operation.Three fetuses survived rand two fetuses died.After a mean follow-up of 2.2 years (range,1 - 3.5 years ),5 patients were doing well.CT angiogram detected nonmal aortic and valvular structures,with no signs of distal dilation.Three babies were normal in development and neurocognitive functios.Conclusion Palients with aortic dissection associated with pregnancy should be operated on ugently and medical treatment carries high risks of aortic rupture and maternal and fetal death.Methods of surgical repair,peffusion techniques and delivery should be chosen based on the underlying aortic pathology and gestational age,so as to maximize the safety of the mother and her baby.

Objective To investigate the correlation between clinicopathological features and lymph node metastasis (LNM) in early gastric cancer (EGC).Methods From January 2006 to June 2009,the clinical data of 473 patients with EGC were collected.The data of patients including gender,age,tumor size,tumor number,general classification,differentiation degree,invasion depth,ulcer in tumor,nerve invasion,and lymphatic tumor cell embolus were analyzed.Chi-square test was performed to analyze the correlation between clinicopathological features and LNM in EGC.Logistic regression analysis was used to analyze the independent risk factor of LNM in EGC.Results Among 473 patients with EGC,77 patients had LNM and the metastasis rate was 16.3％.The metastasis rate of the female patients (24.6％,41/167) was higher than that of the male (11.8 ％,36/306).The metastasis rate of the tumors with maximum diameter over 2 cm (22.0％,39/177) was higher than that of the tumors less than 2 cm (12.8％,38/296).The metastasis rate of the elevated lesions (26.1％,6/23) was higher than that of flat and concave lesions (9.0 ％,15/167;19.8％,56/283).The metastasis rate of poorly differentiated tumors was higher than moderate differentiated and high differentiated tumors (12.7 ％,23/181; 7.1％,3/42).The metastasis rate of tumors invading into submucosa (22.9％,41/179) was higher than that of tumors invading into mucosa (12.2％,36/294).The metastasis rate of tumors with lymphatic embolus (40.7％,11/27) was higher than that of tumors without lymphatic embolus (14.8％,66/446) and the differences were statistically significant (x2 =12.960,6.873,10.704,7.382,9.277 and 12.572,all P＜0.05).The results of multifactor analyzed by Logistic regression analysis revealed that female,maximum diameter over 2 cm,poorly differentiated type and invasion to submucosa were the independent risk factors of LNM in EGC (relative risk (RR)=2.53,2.14,1.63 and 2.39,all P＜0.01).Conclusion Female,maximum diameter over 2 cm,poorly differentiated type and invasion to submucosa are the independent risk factors of LNM in EGC.

The quality control of new drug cilnical trial is the effective guaranty for the pharmaceutical safety and effective after available on market. Enhancing the inspection and quality control of new drug clinical trials provide the crucial importance to achieve a persistent profitable standard. This paper mainly discussed the problems of current clinical trials based on annual check of drug clinical trial institution.
Clinical Trials as Topic ; Drug Evaluation ; Health Facilities ; Humans ; Quality Assurance, Health Care ; Quality Control

The combined application of statins that inhibit HMG-CoA reductase and fibrates that activate PPAR-α can produce a better lipid-lowering effect than the simple application, but with stronger adverse reactions at the same time. In the treatment of hyperlipidemia, the combined administration of TCMs and HMG-CoA reductase inhibitor in treating hyperlipidemia shows stable efficacy and less adverse reactions, and provides a new option for the combined application of drugs. In this article, the pharmacophore technology was used to search chemical components of TCMs, trace their source herbs, and determine the potential common TCMs that could activate PPAR-α. Because there is no hyperlipidemia-related medication reference in modern TCM classics, to ensure the high safety and efficacy of all selected TCMs, we selected TCMs that are proved to be combined with statins in the World Traditional/Natural Medicine Patent Database, analyzed corresponding drugs in pharmacophore results based on that, and finally obtained common TCMs that can be applied in PPAR-α and combined with statins. Specifically, the pharmacophore model was based on eight receptor-ligand complexes of PPAR-α. The Receptor-Ligand Pharmacophore Generation module in the DS program was used to build the model, optimize with the Screen Library module, and get the best sub-pharmacophore, which consisted of two hydrogen bond acceptor, three hydrophobic groups and 19 excluded volumes, with the identification effectiveness index value N of 2. 82 and the comprehensive evaluation index CAI value of 1. 84. The model was used to screen the TCMD database, hit 5,235 kinds of chemical components and 1 193 natural animals and plants, and finally determine 62 TCMs. Through patent retrieval, we found 38 TCMs; After comparing with the virtual screening results, we finally got seven TCMs.
Acyl Coenzyme A ; metabolism ; Animals ; Databases, Factual ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Hydrophobic and Hydrophilic Interactions ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; chemistry ; pharmacology ; Lipid Metabolism ; drug effects ; Lipids ; blood ; Medicine, Chinese Traditional ; Models, Molecular ; Quantitative Structure-Activity Relationship ; Technology