ARDS is a type of acute diffuse lung injury, characterized by inflammation leading to increased pulmonary vascular permeability and loss of aerated lung tissue, the clinical manifestations are refractory hypoxia, progressive respiratory distress and non cardiac pulmonary edema.ARDS mortality rate is very high, especially in patients with severe ARDS, about 27%-45%. In order to improve diagnostic specificity, a revised definition was published in JAMA in 2012, but no new biomarkers or parameters were adopted.Along with the progress in understanding the pathophysiology of ARDS, a variety of humoral factors by inflammation and molecules derived from injured tissues or activated cells may be potential biomarkers for clinical.

Objective To study the efficacy on prevention of constipation after stroke through abdominal massage and navel therapy with fructus evodiae.Methods 120 patients of stroke with yin-type syndrome were divided into the observation group and the control group with 60 cases in each group.The control group was given routine nursing,the observation group was given abdominal massage and naval therapy with fructus evodiae based upon routine therapy.Comparisons were made about incidence rate of constipation after stroke and applications of non-retention enema with normal saline.Results There were statistical significances of incidence rate of constipation after stroke and applications of non-retention enema with normal saline.Conclusions Abdominal massage and navel therapy with fructus evodiae are good to constipation after stroke.

Dyslipidemia is one of the most common complications of primary biliary cholangitis (PBC). This article reviews the latest research on lipid profile, the risk of cardiovascular diseases, and treatment of PBC with hyperlipidemia. Different from other liver diseases, PBC with hyperlipidemia has a unique lipid profile, which changes dynamically with disease progression. It is generally not considered that there are increased risks of atherosclerosis and cardiovascular disease. For those who have indications for treatment, statins are recommended as the first choice. In the future, more in-depth systematic studies are needed to clarify its diagnosis, treatment, and management processes.

Background:Cerebellar fastigial nucleus (FN)is involved in regulation of visceral activities such as cardiovascular, ingestion,respiratory,and acute gastric mucosal injury,yet it is unclear whether it participates in the regulation of visceral hypersensitivity and what is the possible mechanism. Aims:To investigate the effect and possible mechanism of glutamic acid (Glu ) injection into cerebellar FN on chronic visceral hypersensitivity in rats. Methods: Chronic visceral hypersensitivity rat model was established by neonatal colorectal distension (CRD). After 8 weeks,the rats were divided into CRD group,solvent group (0. 2 μL 0. 9% NaCl solution injection into cerebellar FN),high-,medium-,low-dose Glu groups (12,6,3 μg Glu injection into cerebellar FN,respectively),3-MPA +Glu group (12 μg Glu injection after glutamate decarboxylase inhibitor 3-MPA injection into cerebellar FN),Bic + Glu group (12 μg Glu injection into cerebellar FN after GABAAreceptor blocker Bic injection into lateral hypothalamic area). Pain threshold,abdominal withdrawal reflex (AWR)score and abdominal external oblique muscle electromyography (EMG)were used to detect visceral sensitivity,and malondialdehyde (MDA)content and superoxide dismutase (SOD)activity were measured. Results:Chronic visceral hypersensitivity rat model was successfully established. Compared with CRD group,pain threshold was significantly increased (P＜0. 05),AWR score,EMG amplitude,MDA content were significantly decreased (P＜0. 05 ),and SOD activity was significantly increased in a dose-dependent manner in Glu group (P ＜0. 05 ). Compared with 12 μg Glu group,pain threshold was significantly decreased (P＜0. 05),AWR score,EMG amplitude, MDA content were significantly increased (P ＜0. 05),and SOD activity was significantly decreased in 3-MPA +Glu group,Bic+Glu group (P＜0. 05). Conclusions:Glu injection into cerebellar FN can significantly reduce the visceral sensitivity in rats. The mechanism may be that Glu in cerebellar FN produces GABA via glutamate decarboxylase,and then binding GABAAreceptor in lateral hypothalamic area,resulting in increased intestinal mucosal antioxidant capacity, thereby reducing visceral hypersensitivity.