Objective To study the role of maintaining ventilator tubing at low position in prevention of ventilator-associated pneumonia (VAP).Methods From January 2010 through December 2011,110 cases with invasive mechanical ventilation in Intensive Care Unit (ICU) were randomly divided into observation group (n =55) and control group (n =55).The patients of control group were given conventional prevention method including the head elevated 30°-45°.The patients of observation group were given prevention method of keeping ventilator tubing at low position in addition to conventional prevention method so as to avoid the condensate in ventilator tubing into the airway.After mechanical ventilation support for 28 days,the incidence of VAP,duration of mechanical ventilation,length of ICU stay,incidence of condensate flowing back,clinical pulmonary infection score (CPIS) and mortality were respectively recorded.At the same time,risk of mistakenly extubation by nurses was recorded.Results The comparison between two groups showed the incidence of VAP (16.36％ vs.34.55％),duration of mechanical ventilation (5.86 ± 2.66) d vs.(11.24 ± 3.80) d,length of stay in the ICU (13.60 ± 4.83) d vs.(19.58 ±5.27) d,incidence of condensate backflow (3.64％ vs.49.09％),presenting significant differences between two groups (P ＜ 0.05).The CPIS of observation group was lower than that of the control group (P ＜0.05),and the mortality in observation group (21.82％) was lower than that in the control group (27.27％),but the difference was not significant (P ＞0.05).There was no statistically significant difference in risk of mistakenly extubation between two groups (P ＞ 0.05).Conclusion Maintaining the ventilator tubing at low position can reduce the incidence of VAP,improve the prognosis,and the risk of mistakenly extubation did not increase compared with the conventional methods

Objective To investigate the effect of early airway bundle intervention on prevention ventilator-associated pneumonia(VAP) in ICU patients.Methods One hundred and twenty-eight patients with invasive mechanical ventilation in ICU were randomly divided into the control group (64 cases) and observation group(64 cases).Patients in the control group were given conventional airway intervention,and in the observation group were given airway bundle intervention within 4 h including dumping of condensed water in tubing of breathing machine in time,keeping pressure of artificial airbags from 20 to 30 cm H2 O,chest physical therapy 2 h/time,continuous aspiration of subglottic secretion,using moisture exchanger in breathing machine,and mouth rinse by chlorhexidlne 4 h/time.Incidence of VAP,duration of mechanical ventilation,duration of stay in the ICU and mortality within 28-day were recorded.Clinical Pulmonary Infection Score (CPIS) and APACHE Ⅱ at 0,3rd,5th,7th,14th day were recorded respectively.Results The incidence of VAP,duration of mechanical ventilationand duration of stay in the ICU in observation group were 18.75％,(6.26 ± 2.89) d,(11.88 ± 3.97) d respectively,lower than those in control group (35.94％,(10.54 ± 4.36) d,(16.55 ±5.22) d)),and the differences were significant (x2=4.758,t =6.546,t =6.546,P＜0.05 orP＜0.01).At 3rd,5th,7th,14th day after diagnosed VAP,CPIS of patients with confirmed VAP in observation group were 7.01 ±2.24,5.67 ±2.14,4.36 ± 1.44,2.75 ± 1.37 respectively,lower than those in control group(8.74 ± 2.33,7.51 ± 2.27,6.95 ± 2.98,6.53 ± 2.88,and the differences were significant (Finter group =27.22,P ＜ 0.001 ; Fbetween group =29.41,P ＜ 0.001 ; Finteraction =4.35.P ＜ 0.01).APACHE Ⅱ were 17.02 ± 7.06,15.01 ± 6.06,12.40 ± 4.17,8.40 ± 2.57 respectively,significant lower than those in control group ((22.48 ±7.31,19.67 ± 7.14,16.13 ± 5.33,13.10 ± 4.93),and the differences were significant (Finter group =47.43,P ＜ 0.001 ; Fbetween group =45.36,P ＜ 0.001 ; Finteraction =4.25,P ＜ 0.01).Conclusion Early using airway bundle interventions on ICU patients can reduce the incidence of VAP,improve the condition and prognosis.

Objective To investigate the effect of early using periplaneta americana extract on gastrointesti-nal function in critically patients with infection,and to evaluate its possible mechanism.Methods 66 patients with infection in Intensive Care Unit(ICU)were divided into control group and treatment group(33 cases in each group) according to the random number table.All patients in the two groups were given conventional cluster treatment,the patients in the treatment group additionally received periplaneta americana extract.At the beginning of treatment and 3,7 and 10 days after treatment,the indicators of bowel sounds,gastrointestinal function,APACHEⅡ and blood lactic acid level were respectively tested or recorded.Results At the beginning of treatment,there were no statistically sig-nificant differences between the two groups in terms of gastrointestinal function,bowel sounds,APACHE II score and blood lactic acid level(t =0.132,0.201,0.329,0.190,all P >0.05).3,7 days after treatment,the gastrointestinal function[(1.56 ±0.49)points vs.(1.32 ±0.45)points,(1.27 ±0.44)points vs.(1.02 ±0.42)points],bowel sounds[(1.58 ±0.76)times/min vs.(2.27 ±0.75)times/min,(2.15 ±0.91)times/min vs.(3.11 ±0.97)times/min],APACHE II score[(19.61 ±4.02)points vs.(17.50 ±4.37)points,(17.69 ±3.94)points vs.(15.24 ± 3.82)points]and blood lactic acid level[(2.94 ±0.88)mmol/L vs.(2.45 ±0.75)mmol/L,(2.51 ±0.59)mmol/L vs.(2.20 ±0.55)mmol/L],the terms in the treatment were better than those in the control group,the differences were statistically significant(t3 =2.072,t7 =2.361;t3 =3.712,t7 =4.146;t3 =2.041,t7 =2.565;t3 =2.434,t7 =2.208,all P <0.05).Conclusion Early using periplaneta americana extract has protective effect on gastrointestinal function in critically patients with infection,and improve the condition in a certain degree.

Objective The aim of this study was to investigate the molecular regulatory mechanism of cancer susceptibility candidate 15(CASC15),a long-stranded non-coding RNA(lncRNA),in hepatocellular carcinoma(HCC).Methods Bioinformat-ics methods were used to predict the expression of target genes and analyze the relationship between the expression of target genes and the survival time of patients;Hepatocellular carcinoma tissues and adjacent tissues from patients with HCC were collected;CCK-8,Tr-answell,and flow cytometry experiments were used to detect proliferation,invasion,migration and apoptosis of SMMC7721 cells and Huh-7 cells;The dual-luciferase assay was used to detect the targeting relationship between miR-144-3p and CASC15,as well as leucine rich repeat containing protein 1(LRRC1);RT-qPCR and Western blot were used to detect mRNA and protein expression of target genes;Immunofluorescence was used for protein localization of target genes;Replicate experiment was performed to verify the effect of CASC15/miR-144-3p/LRRC1 on the progression of HCC.In vivo experiment was performed to verify the effect of CASC15 on HCC progression.Results TCGA database and RT-qPCR assay showed high expression of CASC15,low expression of miR-144-3p,and high expression of LRRC1 in HCC tissues and cells(P<0.05).The results of cell function experiments on proliferation,inva-sion and migration showed that CASC15 and LRRC1 played a promoting role in tumor development,while miR-144-3p had an inhibi-tory effect,consistent with the results of apoptosis experiments(P<0.05).Cell function experiments showed that CASC15 inhibited miR-144-3p function,miR-144-3p inhibited LRRC1,and CASC15 bound to miR-144-3p,leading to the upregulation of LRRC1.The replicate experimental results indicated that CASC15 promoted LRRC1 expression through inhibiting miR-144-3p,thereby pro-moting HCC cell proliferation,invasion and migration,and inhibiting apoptosis.Conclusion CASC15 may promote HCC progression by regulating the miR-144-3p/LRRC1 axis.

Objective: To investigate the helping role of Kangfuxin liquid on early enteral nutrition in craniocerebral injury patients with mechanical ventilation, and the indirect effect on mechanical ventilation. Methods: 60 craniocerebral injury patients with mechanical ventilation and early enteral nutrition were selected, and they were randomly divided into treatment group and control group according to the digital table, 30 cases in each group.All patients were given conventional treatment and nutritional support, the patients in the treatment group were given Kangfuxin liquid.Before and 7 days after treatment, the levels of albumin(ALB), pre albumin(PA) and totalprotein(TP) were tested.The incidence of abdominal distension, reflux and aspiration in 7 days were recorded.The time of mechanical ventilation and the stay time in ICU were recorded.The mortality rate in 28 days was recorded. Results: 7 days after treatment, the levels of ALB[(33.47±4.82)g/L vs.(30.47±4.64)g/L], PA[(206.21±41.87)mg/L vs.(185.62±38.94)mg/L]and TP[(57.82±5.96)g/L vs.(54.47±6.17)g/L]in the treatment group were higher than those in the control group(t=2.456, 2.338, 2.139, all P<0.05). The incidence rates of abdominal distension(20.00% vs.53.33%), reflux(16.67% vs.43.33%), time of mechanical ventilation[(11.76±2.02)d vs.(13.02±1.96)d]and the stay time in ICU[(13.74±2.31)d vs.(15.43±2.14)d]in the treatment group were lower than those in the control group(χ²=7.177, 5.07, t=2.452, 2.940, all P<0.05). There was no statistically significant difference in 28-day mortality rate (P>0.05). Conclusion Kangfuxin liquid has helping role on early enteral nutrition in craniocerebral injury patients with mechanical ventilation.And it is helpful to shorten the time of mechanical ventilation.