Objective To evaluate the effects and security of single or combined sufentanil application on sedation and analgesia for mechanically ventilated patients in intensive care unit(ICU).Method A total of 160 ICU patients with mechanical ventilation were randomly allocated into four groups:sufentanil group,sufentanil plus midazolam group,sufentanil plus dexmedetomidine group and fentanyl group.Facial pain scale(FPS),Ramsay score and vital signs were employed to assess the effects of different therapies on organ functions and adverse reactions.Result After the treatment,FPS in all groups were significantly decreased and maintained around 3 points.Ramsay scores were significantly increased(P <0.001)and the score in group given sufentanil combined with midazolam or dexmedetomidine at the time points of30 min,1 h,6 h were even higher.Compared with the preoperative data,indicators of lung function(PaCO2and blood lactic acid),liver function(AST)and renal function(Cr)were decreased in all groups(P <0.05).Respiratory rate in the fentanyl group was significantly higher than the others.Total consumption ofsufentanil in group with combined sufentanil application was significantly lower.No significant differencesin adverse reactions were noticed among the groups(P >0.05).Conclusion For mechanically ventilatedpatients,sufentanil has efficient sedative and analgesic effects with less physiological interference and severe adverse reactions.Combined application is beneficial in decreasing total sufentanil consumption andinhibition to respiratory system,which is worthy of being spread.

AIM: To study the effect of bFGF on cell proliferation, secretion of type I collagen and expression of integrin ? 1 in human kidney fibroblasts (KFB). METHODS: The KFB was cultured and stimulated by bFGF in vitro. The proliferation and collagen I secreting of KFB, the expression of integrin ? 1 were measured by MTT, ELISA and flow cytometer, respectively. RESULTS: bFGF (25-50 ?g/L) could obviously stimulate the cell proliferation ( P

OBJECTIVE To learn the epidemiology of respiratory infection in ICU and non-ICU wards,and analyze the difference of drug resistance of Gram-negative bacilli between those two wards in order to provide the basis of empirical therapy for the respiratory infection from the different wards.METHODS The bacteria were identified by VITEK-2 and API system.Antibiotic sensitivity test adopted by K-B method.Data were analyzed by WHONET 5.3 software.RESULTS Totally 2184 strains of Gram-negative bacilli were isolated all from the respiratory tract,among which 655 strains were isolated from ICU ward and 1529 strains were from non-ICU ward.In ICU ward,the first five bacteria were Pseudomonas aeruginosa,Burkholderia cepacia,Acinetobacter baumannii,Chryseobacterium meningosepticum,and Stenotrophomonas maltophilia.It showed that non-fermentatives were the main pathogenic bacteria in ICU.In non-ICU ward,the first five bacteria were P.aeruginosa,Klebsiella pneumoniae,A.baumannii,B.cepacia,and S.maltophilia.Drug resistant rate of strain from ICU ward was generally higher than that from non-ICU ward,while levofloxacin in ICU ward showed the better activity than in non-ICU ward.CONCLUSIONS The respiratory infection is one of the hazards in nosocomial infection,drug resistant rate of Gram-negative bacilli from respiratory specimen in ICU is generally higher than that in non-ICU,and the main strains are the mlti-resistant non-fermentatives,which should attract the clinician′s more attention.

Objective To evaluate the efficacy of continuous positive airway pressure (CPAP)-based standard treatment on obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with type 2 diabetes and insulin resistance (IR) in the elderly.Methods 63 elderly type 2 diabetes patients diagnosed as OSAHS were randomly divided into control group (n =31) and CPAP group (n =32).Patients in control group were treated with conventional therapy including diet control,exercise and antidiabetic drugs,and patients in CPAP group were treated with CPAP treatment combined with conventional therapy.Fasting glucose (FBG),oral glucose tolerance test (OGTT),homeostasis model assessment of IR index (HOMA-IR),body mass index (BMI),apnea-hypopnea index (AHI),lowest oxygen saturation (L-SaO2) and the dosage of insulin application were observed after 7 days,1 month,3 months of the treatment.Glycosylated hemoglobin (HbA1c) was determined before and after 3 months of the treatment.Results In CPAP group,levels of FBG and 2 h OGTT glucose,HOMA-IR,AHI,daily insulin dosage were significantly reduced and L-SaO2 was significantly increased after 7 days of the treatment; BMI was significantly reduced after 1 month of the treatment;HbA1c level was significantly reduced after 3 months of the treatment.In control group,L-SaO2 was significantly reduced along with the multiple time points; daily insulin dosage was significantly increased after 3 months of the treatment.There were no significant differences in all observed indicators between groups before treatment.There were significant differences in the observed indicators between groups after treatment except for BMI after 7 days of the treatment.Conclusions Compared with conventional therapy,CPAP-based standard treatment has more efficacy on increasing insulin sensitivity and improving insulin resistance in elderly patients with OSAHS and type 2 diabetes.

Objective To seek differentially expressed proteins for human epithelial growth factorreceptor-2 (HER-2)negative and positive breast carcinoma through establishing proteins profiles,and to providenew prognostic markers and therapeutic targets for patients with breast cancer.Methods HER-2 positiveand negative breast cancer protein expression profiles were established using proteomic isobaric tags for relativeand absolute quantitation (iTRAQ)technology.Differences of protein expression were identified and parts ofdifferential expression proteins were analyzed by bio-informatics,including protein function annotation and GOclassification analysis and Kyoto Encyclopedia of Gene and Genome (KEGG)pathway analysis.Results Proteomicanalysis of breast cancer tissue with identified HER-2 positive and negative groups showed 4 999 differentiallyexpressed proteins by iTRAQ.Based on the criteria of the ratio of HER-2(+)/HER-2(-)≥3,119up-regulated proteins were identified in HER-2 positive group.Based on the criteria of the ratio of HER-2(+)/HER-2(-)≤0.5,47 down-regulated proteins were identified in HER-2 positive group.The results ofGO analysis showed that the molecular function,biological process and cellular composition of differentiallyexpressed proteins were complex between HER-2 positive and negative breast cancer.There were differences inthe distribution of up-regulated proteins and down-regulation of proteins.KEGG pathway analysis showed thatdifferentially expressed proteins involved in 168 signal pathways.Conclusion There are differentiallyexpressed proteins between HER-2 positive and negative breast cancer,which involve complex molecular func-tion,biological process and signaling pathway.

The paper presented the implementation of the healthcare reform policy and initial success of Xinyu TCM Hospital in its reform pilot work of public hospital reform in Xinyu city ,Jiangxi province. The authors also analyzed problems and causes of the hospital in business development and cost control during the reform ,proposing to carry out TCM development policy ,enhance government investment ,streamline TCM service pricing ,and innovate TCM supporting model. In addition ,they also proposed TCM hospitals to enhance management ,and reform their mechanism to resolve such problems as high operating costs ,and poor talent development and lack of feature disciplines .

There is a unclear understanding whether occupatioal therapy is needed by patients whohave injuries or diseases.113 cases of patients with different diagnoses were interviewed in this study. The measurement tool used was Canadian Occupational Performance Measure (COPM).Statistical anal-ysis showed that all of patients had identified and prioritized problems with occupational performancesecondary to injuries or diseases. Occupational therapy intervention was required to solve the problemsin different occupational performance areas. COPM is an useful measurment tool in the model of patient-centered occupational therapy and is well worth recommending in clinical use.

At present, TCM treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) is based on the combination of disease differentiation and syndrome differentiation. Therefore, the establishment of IBS-D of liver stagnation and spleen deficiency syndrome combined with animal model as a combination of traditional Chinese and Western medicine innovation theory has become increasingly concerned about, and gradually become a new direction for the development of TCM experimental animal model. This article reviewed the research progress in IBS-D liver and spleen deficiency syndrome in recent years, discussed the establishment of IBS-D liver stagnation and spleen deficiency animal model and research ideas for the treatment of IBS-D, and provided references for mechanism research of TCM treatment for IBS-D and research and development of new medicine.

Objective:To explore the associations between thyroid function in the first trimester in twin pregnancies and gestational diabetes mellitus (GDM) and the risk factors of twin pregnancies complicated by GDM.Methods:Retrospective analysis was performed on 745 twin pregnancies delivered after 28 weeks at the Third Affiliated Hospital of Sun Yat-sen University from January 2015 to December 2021, and they were divided into GDM group ( n=186) and the control (non-GDM) group ( n=559). Thyroid dysfunction was diagnosed based on the reference range of singleton and twin pregnancies recommended by the Guideline on diagnosis and management of thyroid diseases (2nd edition) in China and the literature, respectively. Independent sample t-test, Chi-square test, or Fisher exact test, and Mann-Whitney U test were used to compare the general clinical characteristics and thyroid function between the two groups. Spearman rank correlation analysis was performed to analyze the correlation between free thyroxine (FT 4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and fasting plasma glucose (FPG) in the first trimester as well as glucose levels in 75 g oral glucose tolerance test (OGTT). The associations between FT 4, TSH at different levels, and the detection rate of GDM, and the risk factors of GDM in twin pregnancies were analyzed using logistic regression. Results:(1) The prevalence of GDM in twin pregnancies was 25.0% (186/745). The positive rate of TPOAb was 13.6% (101/745). FPG in the first trimester was higher in the GDM group than that in the control [(4.7±0.5) vs (4.5±0.4) mmol/L, t=－5.08, P<0.001]. (2) No correlation between FT 4, TSH levels, the positive rate of TPOAb in the first trimester and FPG in the first trimester as well as OGTT results was found (all P>0.05). (3) There was no significant difference when using the thyroid function reference range for twin or singleton pregnancy in detecting hypothyroidism [0.5% (4/745) vs 0.4% (3/745)] and subclinical hypothyroidism [1.2% (9/745) vs 1.3% (10/745)] among the included subjects (both P>0.05), however, there were significant differences in the detection rates of hypothyroxinemia alone [25.0% (186/745) vs 12.9% (96/745)], hyperthyroidism [2.4% (18/745) vs 12.9% (96/745)] and subclinical hyperthyroidism [5.8% (43/745) vs 12.1% (90/745)]( χ2 were 35.43, 33.43 and 18.24, all P<0.001). There was no significant difference in the detection rate of thyroid disease between the GDM and control groups (all P>0.05). (4) FT 4 and TSH levels were grouped into quartiles ( Q1, Q2, Q3, and Q4), which showed that the detection rate of GDM was the highest [27.8% (52/187)] in women with FT 4 in Q1 and was the lowest [23.0% (43/187)] in those with FT 4 in Q2. However, the detection rate was the lowest in women with TSH in Q1 [24.1% (45/187)] and was the highest [27.4%(51/186)] in those with TSH in Q4. Taking Q1 of FT 4 and TSH as a reference, the logistic regression model showed that there were no statistically significant differences between FT 4, TSH at different levels, and GDM, even after adjusting for age, preconception-body mass index (pre-BMI), family history of diabetes, mode of conception, and chorionicity (all P>0.05). (5) Multivariate logistic regression analysis showed that maternal age ( OR=1.10, 95% CI: 1.05-1.15), pre-BMI ( OR=1.13, 95% CI: 1.07-1.21), family history of diabetes ( OR=2.73, 95% CI: 1.53-4.85), and FPG in the first trimester ( OR=2.14, 95% CI: 1.38-3.32) were independent risk factors for twin pregnancies complicated by GDM. Conclusions:Twin pregnant women with higher maternal age, pre-BMI, FPG in the first trimester and family history of diabetes were at higher risk of GDM. No significant correlation is found between maternal thyroid function in the first trimester and GDM in twin pregnancies.