Objective To investigate the impacts of Xuebijing injection on systemic inflammatory response and immune function of patients with acute exacerbation of severe chronic obstructive pulmonary disease (AECOPD). Methods A prospective randomized controlled trial (RCT) was conducted. Forty patients with severe AECOPD were divided into control group and Xuebijing group in accordance with the random number table, each group 20 cases. Both groups were treated by routine conventional basic therapy of severe AECOPD including anti-infection, phlegm-expelling formula, bronchodilators and mechanical ventilation, etc, while in Xuebijing group, intravenous drip of Xuebijing (100 mg, twice a day for 5 days) was additionally used. The changes of data of arterial blood gas analysis, blood routine examination, C-reactive protein (CRP), procalcitonin (PCT), immune function, and acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score before and after therapy were observed and compared between the two groups. The length of stay in hospital, duration of mechanical ventilation, and prognosis were also compared between the two groups. Besides, according to the difference in APACHE Ⅱ score, all the patients were divided into APACHEⅡscore≥15 score group (18 cases) and APACHEⅡscore<15 score group (22 cases), and the immune function were compared between the two groups. Results ①The immune function was descended and disordered in patients with severe AECOPD. Compared with the < 15 score group, the expressions of CD45+, CD3+, CD4+, CD4+/CD8+ ratio, B-lymphocyte, natural killer cell (NK cell) in ≥ 15 score group were significantly lowered [CD45+(×106/L):663.92±100.61 vs. 1 289.92±169.38, CD3+(×106/L):342.05±108.93 vs. 882.37±172.56, CD4+(×106/L):205.96±63.97 vs. 486.24±108.64, CD4+/CD8+ratio:0.76±0.49 vs. 1.32±0.57, B-lymphocyte (×106/L):124.77±32.72 vs. 166.06±48.02, NK cells (×106/L): 186.47±39.57 vs. 243.51±44.72, all P < 0.05]. There was no statistically significant difference in the expression of CD8+ between the ≥ 15 score group and < 15 score group (P > 0.05). ② Compared with those before therapy, the pH value, oxygenation index, arterial partial pressure of carbon dioxide (PaCO2), white blood cell count (WBC), CRP, PCT were significantly improved after therapy in both control and Xuebijing groups. Compared with those in the control group, WBC, CRP, PCT were significantly lowered in Xuebijing group [WBC (×109/L): 10.29±3.83 vs. 12.69±3.42, CRP (mg/L): 9.06±4.19 vs. 15.26±4.22, PCT (ng/L): 0.18±0.21 vs. 0.42±0.24, all P < 0.05]. There were no statistically significant differences in pH value, oxygenation index and PaCO2 between two groups (all P>0.05). The degrees of improvement of CD45+, CD3+, CD4+, CD8+ and CD4+/CD8+ ratio were more remarkable in Xuebijing group after treatment than those in control group [CD45+ (×106/L): 1 079.38±153.86 vs. 1 015.63±157.11, CD3+ (×106/L): 652.05±100.05 vs. 596.81±106.85, CD4+ (×106/L): 358.92±67.53 vs. 329.99±72.61, CD8+ (×106/L): 205.73±35.19 vs. 230.41±39.74, CD4+/CD8+ratio: 2.16±0.63 vs. 1.52±0.54, all P < 0.05]. The B-lymphocyte and NK cell before treatment and after treatment showed no statistical significant differences between the two groups (all P > 0.05). Compared with the control group, the duration of mechanical ventilation (hours: 56.25±22.87 vs. 69.45±26.59) and the length of stay in hospital (days: 11.00±0.74 vs. 14.00±2.06) were shortened, and APACHE Ⅱ score was significantly lowered in Xuebijing group (8.21±2.97 vs. 12.08±3.12, P < 0.05). The numbers of multiple organ failure and dead patients in Xuebijing group were less than those of control group, but no statistical significant differences were found (both P > 0.05). Conclusion Xuebijing injection for treatment of patients with severe AECOPD can ameliorate inflammatory response, improve immune function, shorten the duration of mechanical ventilation and the length of stay in hospital, and decrease the risk of death.

Objective To understand the clinical distribution and drug resistance situation of112 strains of Acinetobacter Bau-mannii isolated from the patients′sputum samples in cerebral surgery ICU in order to provide the basis for the rational use of anti-bacterial drugs in clinical therapy.Methods 112 strains of Acinetobacter Baumannii were performed the retrospective analysis.The VITEK2-Compact automatic microbiological analyzer was adopted to conduct the bacterial identification and the drug susceptibility test and the K-B method was combined as the supplement control.The Whonet 5.6 software was used for conducting the statistical analysis.Results Among 112 strains of Acinetobacter baumannii,75 strains(67.0%)were multi-drug resistant,8 strains(7.1%) were pan-resistant.The antimicrobial susceptibility tests showed that the resistant rates of Acinetobacter baumannii to mezlocillin, piperacillin and nitrofurantoin reached up to 100%.Acinetobacter Baumannii had the lower resistant rate to polymyxin B (2.7%), the resistant rates to minomycin and ceperazone/sulbactam were 4.5% and 10.7% respectively.Conclusion The drug resistance phenomena of Acinetobacter Baumannii in the cerebral surgery department ICU is serious.Minomycin,polymyxin B and ceperazone/sulbactam have the better antibacterial activities to clinically isolated Acinetobacter Baumannii and may be the alternative drugs for therapy.Clinic should strengthen the monitoring and rationally use the antibacterial drugs.

Culture ; Medicine, Chinese Traditional ; Research ; Translations

Cardiac Catheterization ; trends ; Forecasting ; Heart Defects, Congenital ; therapy ; Humans

Heart Defects, Congenital ; therapy ; Humans

Evidence-Based Medicine ; Humans ; Practice Patterns, Dentists'

Evidence-Based Dentistry ; Humans

Adult ; Burns ; etiology ; Humans ; Male ; Occupational Exposure ; Phosphorus ; adverse effects ; Young Adult

Objective To study the related risk factors and comparison between adenomyosis and uterine myoma in order to find the same and different ways of preventing adenomyosis and uterine myoma.Methods Clinical data of 200 cases of adenomyosis and 200 cases of uterine myoma were retrospectively analyzed.Results There was no significant difference in the incidence of different ages between adenomyosis and uterine myoma (P ＞ 0.05).There were significant differences in A blood type,family history,dysmenorrhea and using intrauterine device between adenomyosis and uterine myoma (85 cases vs.56 cases,9 cases vs.36 cases,163 cases vs.71 cases,104 cases vs.79 cases,P ＜ 0.05),but there was no significant difference in occupation,education,previous gynaecopathia inflammatory disease,age of menarche,menstrual cycle,menstruation,infertility,the first gestational age,parity,abortion numbers between adenomyosis and uterine myoma (P ＞ 0.05).Conclusions The adenomyosis and uterine myoma may be associated with the stimulation by high level of female hormone.Compared with uterine myoma,adenomyosis seems to be related to A blood type,dysmenorrhea and using intrauterine device.

Congenital adrenal hyperplasia(CAH) is a family of autosomal recessive disorders.The most frequent form of the disease is steroid 21-hydroxylase deficiency,which accounts for more than 90％ of all cases of CAH.In the pathogenesis of CAH,the cortisol synthesis impairement leads to excessive ACTH secretion of the adrenal glands,which ultimately results in adrenal hyperplasia and androgen overproduction.CAH causes signs of androgen excess including ambiguous genitalia in newborn females and rapid postnatal growth in both sexes.In the most severesalt wasting form of CAH,concomitant aldosterone deficiency may lead to salt wasting with life-threatening adrenal crises.Newborn screening,especially in males,reduces morbidity and mortality from adrenal crises.Glucocorticoid replacement remains the cornerstone of treatment.However,how to make a suitable therapeutic regimen of CAH is still a challenge to the pediatric clinician.