ObjectiveTo investigate the value of high flow nasal cannula (HFNC) in treating a patient with Middle East respiratory syndrome (MERS).Methods The effect of HFNC applied in the first imported MERS patient with complication of acute respiratory distress syndrome (ARDS) to China was observed. The patient was admitted to Department of Critical Care Medicine of Huizhou Municipal Central Hospital on May 28th, 2015, and the changes in various clinical parameters and their significance were analyzed.Results A 43-year old male was admitted to negative pressure isolation intensive care unit with the complaint of back ache for 7 days and fever for 2 days. Vital signs and saturation of pulse oximetry (SpO2) were monitored continuously. After admission, ribavirin was given orally for 12 days andα-interferon was administered once on the first day. However, after 2-week anti-virus therapy, the virus test was positive. Ceftriaxone was given on the 4th day, and it was changed to meropenem on the 3rd day for 2 weeks. Immune globulin was given on the 4th day and continued for 1 week. Thymosin-α1 was given on the 8th day and continued for 2 weeks. According to his past history, methimazole had been given continuously for hyperthyroidism and other symptomatic treatment. Oxygen inhalation (6 L/min) was given immediately after admission, but the condition of patient worsened with the following symptoms: frequent cough and obvious shortness of breath. Moreover pleural effusion gradually increased as shown by X-ray. SpO2 was maintained only at about 0.91. Oxygenation index (PaO2/FiO2) decreased to 144 mmHg (1 mmHg = 0.133 kPa). So oxygen inhalation via nasal cannula was changed to HFNC after 2 days. The parameters were set as follows: temperature 34℃, flow rate 20 L/min, fraction of inspired oxygen (FiO2) 0.50. The flow was raised 5 L/min every 10 minutes, and was continued till the target value reached 60 L/min. FiO2 was modified according to SpO2 and PaO2/FiO2. FiO2 was set to 0.80 on the 5th day of admission. Shortness of breath of the patient was improved on the 7th day of admission after the application of HFNC. FiO2 was then decreased to 0.58 as PaO2/FiO2 rose. Then the flow was gradually decreased to 30 L/min. HFNC was reduced with continuous improvement in PaO2/FiO2. HFNC was changed to low flow oxygen inhalation nasal cannula (2-3 L/min) on the 20th day. Oxygen treatment was stopped on the 23rd day, and SpO2 was maintained at 0.98-1.00. Activities on bed were gradually increased. The patient was cured and discharged from hospital on June 26th. The patient showed good tolerance and high compliance during the treatment with HFNC. No nosocomial spread occurred during the treatment.ConclusionsHFNC could improve respiratory function of the patient with MERS obviously, and complication ARDS was prevented. HFNC might reduce nosocomial spread.

0.05). In active SLE, the CD3~+HLA-DR~+, CD4~+HLA-DR~+ and CD8~+ HLA-DR~+ cells of BM were all higher than those of peripheral blood in the control group(P

OBJECTIVETo analyze the rules for acupoint selection of acupuncture and moxibustion in domestic clinical treatment of perimenopausal syndrome based on data mining technology in modern times.

METHODSThe relevant literature were retrieved from Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI) and Wanfang database on this disease treated with clinical acupuncture and moxibustion in China from 1978 to 2013. The database of acupuncture-moxibustion prescription was set up. The relevant regulations of data mining technology were used to analyze the rules for acupoint selection.

RESULTSTotally, 211 papers, 254 acupuncture-moxibustion prescriptions and 130 acupoints were included. The total frequency of acupoints application was 2193 times, with 14 meridians involved. The utilization of the acupoints in the lower limbs and on the back were 33.0% (723/2193) and 23.8% (521/2193) and those of yin and yang meridians were 51.8% (1136/2193) and 44.0% (965/2193), respectively. The utilization of the specific acupoints accounted for 88.7% (1946/2193).

CONCLUSIONIn clinical treatment of perimenopausal syndrome with acupuncture and moxibustion in modern times, the acupoint selection from involved meridians is the basis, associated with multiple methods of acupoint combination; yin and yang meridians are equally important and the specific acupoints are considered particularly critical in application.

Acupuncture Points ; Acupuncture Therapy ; China ; Clinical Trials as Topic ; Female ; Humans ; Perimenopause ; physiology

Objective To explore the effect of Bailing capsule on epithelial-mesenchymal transition( EMT) in rats with adenine-in-duced tubulointerstitial fibrosis. Methods Tubulointerstitial fibrosis animal models were established and SD rats were divided into mo-del group ( n = 30), treatment group ( n = 30) and control group( n = 30), randomly. Experimental rats were harvested at 7 w, 12 w,17 w after onset of experiment and functional evaluations were performed. Histology, immunohistology were examined to investigateboth histolopathology changes and the expression of bone morphogenic protein-7 (BMP-7), transforming growth factor-β1 (TGF-β1 )and a-smooth muscle actin (α-SMA) in kidneys at three time points mentioned above, respectively. Results Compared with controlgroup, 24 h urinary protein in model group lost increasingly and significantly difference appeared at three time points relative to controlgroup ( P ＜ 0.01 ). Urinary NAG in model group was markedly higher than that in control group from 7 w after onset (P ＜ 0.01 ) andwas increasingly raised at 12 w and 17 w (P＜0.01). The value of blood BUN and Cr in model group increased at 7 w (P＞0.05) rel-ative to control group. There was significant difference at 12 w and 17.w (P ＜ 0.01 ). Histologically, kidneys in model group, at 7 w,exhibited tubular casts and gently tubular dilation, granuloma in cortex, mononuclear cells infiltration in tubulointerstitial areas, andmild interstitial fibrosis. At 12 w, the degree of tubular injury and tubulointerstitial fibrosis gradually aggravated. Up to 17 w, diffusetubular dilation or atrophy was observed and focal tubules disappear. Diffuse interstitial fibrosis was exhibited. In normal kidneys, im-munohistochemistry suggested that the light expression of BMP-7 was detected in proximal renal tubular epithelial cells and marked ex-pression was identified in distal tubule, collecting duct, and renal tubular epithelial in junction area between cortex and medulla. How-ever, the expression of BMP-7 in kidneys of model group significantly decreased with increasing tubulointerstitial fibrosis and was nega-tive correlation with the expression of TGF-β1(r = -0. 981 P＜0.01) and α-SMA (r= -0.975 P＜0.01). Bailing capsule ad-ministration protected the expression of BMP-7 and reduced TGF-β1 and α-SMA expression before 12 w(P＜ 0.01 ). Conclusions Ourstudy shows an anti-fibrotic reno-protective function of Bailing capsule in rats with tubulointerstitial fibrosis via prevention of epithelial-mesenchymal transition at early stage. However, the beneficial effect lost with increasing tubulointerstitial fibrosis.

Objective To investigate the relationship between pure -tone audiometry (PTA ) ,speech dis‐crimination abilities in quiet or in noise and the international outcome inventory for hearing aids (IOI-HA) in pres‐bycusis patients .Methods Twenty presbycusis subjects were tested in this study .Pure-tone audiometry (PTA) and speech discrimination threshold were obtained before being fitted with hearing aids .They weared hearig aids more than six months ,and pure-tone audiometry ,speech discrimination scores in quite(the level = 65 dB SPL) and in noise(signal to noise ratio = 10 dB) were carried out in sound field .A stepwise forward multiple-regression analysis was performed to investigate the impact of PTA and speech discrimination scores to IOI-HA .Results The PTAs before or after hearing aid fittings showed a negative association with IOI-HA ,while speech discrimination scores in quiet or in noise before or after hearing aid fittings showed a positive association with IOI-HA .Speech discrimination threshold in noise was identified as a single predictor of IOI-HA(P<0 .001) .Conclusion The relation between speech discrimination scores in noise and IOI-HA suggests that a poor score might limit the hearing aids outcome .The speech discrimination scores in noise help the clinicians predict the outcomes of hearing aid in real‐ities .

A HPLC method of analysis of Monascus citrinin was established. More than 30 strains of Monascus spp. were cultured in steamed rice at solid state or in MSG liquid medium composed of monosodium glutamate as sole nitrogen source and glucose as sole carbon to investigate their ability of producing citrinin. The results indicated that most of the Monascus strains are able to produce citrinin. MSG medium can be used as a specific culture medium to qualitatively identify if the strain is the potential citrinin producer. But to confirm whether the Monascus strains are potential citrinin producers, these strains should be cultured in several cultivation methods, as the culture states and culture conditions influence the citrinin production greatly.

Objective To explorethe effect of Bailingcapsule on epithelial-mesenchymal transition(EMT) inrats withadenine-in-duced tubulointerstitial fibrosis .Methods Tubulointerstitial fibrosis ani mal models were established and SDrats were dividedinto mo-del group (n=30) ,treatment group (n=30) andcontrol group(n=30) ,randomly .Experi mental rats were harvested at 7 w,12 w,17 wafter onset of experi ment and functional evaluations were performed. Histology ,i mmunohistology were examined to investigateboth histolopathology changes and the expression of bone morphogenic protein-7 (BMP-7) ,transforming growth factor-?1(TGF-?1)and a-smooth muscle actin (?-SMA) in kidneys at three ti me points mentioned above ,respectively .Results Compared with controlgroup ,24 h urinary proteinin model grouplost increasingly and significantly difference appeared at three ti me points relative to controlgroup(P0 .05) rel-ative to control group.There was significant difference at 12 wand 17 w(P

OBJECTIVETo make a comparison between the single and combined use of Monkshood Root and Peony Root to observe the anti-inflammation effect in the experimental animals.

METHODThe experimental inflammatory models were adopted, i.e. adjuvant-induced polyarthritis carrageenan-induced or formaldehyde-induced rat paw edema, and cotton pellet-induced granuloma formation in rats xylene-induced mouse ear edema, exudation of abdominal blood capillaries of mice, etc.

RESULTThe anti-inflammafion effect of Monkshood Root was weaker than that of Peony Root or Peony Root combined with Monkshood Root. It was found that anti-inflammation effect with the drug-cooperation was enhanced more significantly in the formaldehyde-induced or adjuvant-induceed arthritis models than in the carrageenan-induced rat paw edema and other inflammatory models either in the large dosage of 1:1 proportion or in the small dosage of 1:2 proportion.

CONCLUSIONThe drug-cooperation has a good selective and synergic effect on anti-inflammation.

Aconitum ; chemistry ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Edema ; drug therapy ; Female ; Granuloma, Foreign-Body ; drug therapy ; Male ; Mice ; Paeonia ; chemistry ; Phytotherapy ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rats

Objective To investigate the reliability and practicality of Chinese version the hearing handicap in-ventory for the elderly -screening version(HHIE -S) scale for elderly hearing screening in China .Methods We compared the HHIE -S scores with results of pure -tone audiometry test .A total of 840 Chinese individuals older than 60 years filled in the scale all by themselves first ,then refilled it according to explanations of each question translated by researchers .All participants finished pure -tone audiometry test with frequencies of 0 .25 ,0 .5 ,1 .0 , 2 .0 ,and 4 .0 kHz .Sensitivity ,specificity ,positive predictive value (PPV ) ,false-negative rate and false -positive rate were compared with HHIE -S cut -off points of >8 or >10 and pure-tone averages (PTAs) greater than 25 ,40 and 60 dB HL .Analysis the area under the curve (AUC) values of receiver operating characteristic (ROC) curves for each three PTA levels .Results Cronbach's α of the scale was 0 .85 .HHIE -S scale pre -explanatory score was 7 .6 ± 10 .6 ,and post-explanatory score was 10 .8 ± 16 .7(P<0 .01) .HHIE -S> 8 points higher than H HIE-S> 10 points in the sensitivity ,positive predictive value increase ,specificity ,false-positive rate ,false negative rate decreased ,paired samples t - test sensitivity and false -negative rate (P< 0 .05) .After the guide meanwhile HHIE-S cut-off points of > 8 when grouping with PTA> 25 dB HL ,PTA> 40 dB HL and PTA>60 dB HL ,conducted ROC curve analysis ,the AUC value was 0 .70 ± 0 .03 ,0 .84 ± 0 .01 and 0 .88 ± 0 .02 .Conclusion The score of HHIE-S scale>8 points can be used when PTA> 40 dB HL as goal for hearing loss of old people , it can be more accurate after explanations ,so HHIE-S scale can be used as a preliminary hearing screening method for Chinese elderly people .

Objective To evaluate the speech recognition ability in noise enviroment in older adults with age-related hearing loss and to discuss the influences of age ,hearing loss and cognitive function on the ability of speech recognition in noise enviroment .Methods A total of 90 older adults aged over 60 years at the hearing clinic of Xinhua hospital were divided into three groups according to the age ,which were 60~69 y group (88 ears) ,70~79 y group (64 ears) ,> 79 y group (28 ears) .All the participants completed pure tone audiometry ,the Mandarin hearing in noise test (MHINT) and the mini-mental state examination (MMSE) .The pure tone average hearing threshold (PTA) ,signal-to -noise ratio (SNR) of MHINT and MMSE scores were obtained .We used the statis_tical software SPSS 17 .0 to analyze the correlations among age ,PTA ,adaptive SNR and MMSE scores .ResuIts ①PTA and SNR increased with the age .The difference of PTA and SNR for different age groups was statistically sig_nificant (P<0 .01) .②The difference SNR among different PTA groups were significant (P<0 .01) ,and when the influence of MMSE scores was controlled the difference was still significant .There was a significant linear correlation between PTA and SNR (r=0 .326 ,P<0 .01) .MMSE scores decreased with the increasing of PTA ,and there was also a linear correlation between PTA and MMSE scores (-0 .187 ,P<0 .05) .③Adaptive SNR and MMSE scores were correlated (r= -0 .201 ,P<0 .01) ,but there was no significant linear relationship .Besides ,SNR of the cog_nitive function impairment group (<27 points) was significantly greater than that of the normal cognitive function group (27~30 points) (P<0 .01) .However ,among the three PTA groups ,the differences were not statistically significant .ConcIusion The hearing in noise test reflects the ability of speech recognition in noise enviroment in ol_der adults ,and can be used to assess the hearing functions in elder .Speech recognition in noise ,peripheral hearing loss and cognitive functions are relevant .Cognitive functions have an influence on the evaluation of the hearing func_tion for older adults .