Objective To investigate the influence of inspired oxygen fraction (FiO2) on the ratio of PaO2/FiO2(P/F) during the implementation of lung protective ventilation strategy in patients with acute respiratory distress syndrome(ARDS) in order to unravel its clinical significance. Method This was a prospective study of 16 selected patients with ARDS treated with mechanical ventilation ( MV ) to get ratio of P/F in range of 100 to 200 by PEEP≥5 cmH2O and high inspired oxygen. After lung recruitment maneuvers by BiPAP with high pressure (PH) of 40 cmH2O for40 s, the MV was maintained the basic requirement for stabilizing the patients for 30 minutes. A series of FiO2 were set at fractions of 0.5,0.6,0.7,0.8,0.9 and 1in random sequence, and the changes of respiratory mechanics, blood gas and hemodynamics under the different concentrations of FiO2 were analyzed by using SPSS version 13.0 software. Results ( 1 ) The ratio of P/F increased as FiO2 increased, and it's significant as FiO2 increased to 0.7 or above. As the fractions of FiO2 were set at 0.5 and 1. O, the ratios of P/F changed in 24.70% ± 23.36% respectively. ( 2 ) Of them,6 patients ( 37.5% ) treated with FiO2 set at 0.5 had the ratio of P/F ＜ 200, and the fraction of FiO2 was increased to 1.0, the P/F ＞ 200. (3) FiO2 and Qs/Qt were negatively correlated ( r = - 0.390, P = O. 027 ),the higher inspired oxygen fraction, the lower shunt. When the fractions of FiO2 were set at 0.5 and 1.0 ,there was a positive correlation between △Qs/Qt and △P/F( r = 0.82, P = 0.005 ). Conclusions The inspired oxygen fraction affects the ratio of P/F, which may be resulted from shunt and it may influence the diagnosis of ARDS.

Objective To study the clinical significance of plasma ET ,NO ,CGRP and EGF detection after acupuncture at Zusanli pointinpatientswithchronicatrophicgastritis.Methods 36casesofpatientswithchronicatrophicgastritiswereenrolledinthe study ,whose plasma ET ,CGRP ,EGF were measured by using radio immunoassay and NO by using biochemical methods .Results After acupuncture administrated in patients with chronic atrophic gastritis ,whose plasma ET ,EGF significantly decreased ,while CGRP ,NO increased(P<0 .05) .The levels of the 4 test items were significantly different between acupuncture for 7 d and 1 d(P<0 .05) .Conclusion Acupuncture at zusanli point could lead to the regulation of the plasma ET ,CGRP ,NO and EGF ,which has time‐dose effect .

Objectives: To evaluate the effects of glutamine on the nutritional metabolism and permeability of intestinal mucosa in MODS patients.Methods: The randomized and controlled study was designed.Twenty MODS patients were randomly divided into control group and treatment group.The concentration of serum albumin,transferrin and blood sugar,L(lactulose) and M(mannitol) ratio in urine,nitrogen balance,the related complication were compared and obserwed.Results: In treatment group,the concentration of serum albumin,prealbumin and transferrin were higher than that of control group on the same time and showed significant difference(P

OBJECTIVE To investigate spectrum distribution of pathogens in patients with artificial airway and analyze their associated factors.METHODS The clinical data of 27 patients with tracheal intubation or tracheotomy from Mar 2005 to Mar 2006 were analyzed retrospectively.RESULTS Twenty seven patients were diagnosed as pneumonia.A total of 384 isolates of pathogens were collected from 258 sputum culture.The most were Gram-negative bacilli(293 isolates),and then were Gram-positive cocci and fungi.The four most pathogens were Pseudomonas aeruginosa,Stenotrophomonas maltophilia,meticillin-resistant Staphylococcus aureus(MRSA) and Acinetobacter baumannii.More multiple drug resistant(MDR) pathogens were detected in patients two weeks after intubation or tracheotomy than that after one week,and it was the same with sensitive rates to antibiotics of G-bacilli.CONCLUSIONS Patients with artificial airways have a higher morbidity of MDR pathogens and longer retention time of artificial airway can increase infection of MDR pathogens of lower respiratory tract.

Objective To investigate the impacts of valsartan on cell apoptosis induced by angiotensin Ⅱ in vascular smooth muscle cells,and discuss whether the mechanism is relevant to AMP-Activated Protein Kinases.Methods Vascular smooth muscle cells (A7r5) were designated to 5 groups:①control (DMSO) group,②Angiotensin Ⅱ (Ang]Ⅱ) 100 μmo]/L group,③Angiotensin lⅡ 100 μmol/ L + valsartan 10 μmol/L group,④Angiotensin Ⅱ 100 μmol/L + valsartan 10 μmol/L + compound C 1 μmol/L group,⑤ Angiotensin Ⅱ 100 μmol/L + 5-Aminoimidazole-4earboxamide-ribo-nucle-oside (AICAR) 100 μmol/L group,after 24h incubation,the intracellular activity of Caspase 3 was measured by spectrophotometry,the cell apoptosis were enumerated by low cytometry,the intracellular AMP-Activated Protein Kinases (AMPK) phosphorylation and total expression quantity were examined by western blot,the intracellular reactive oxygen species (ROS) was measured by fluorescent probe DCFH-DA,the intracellular activity of total superoxide dismutase (SOD) was measured by WST-1 method,the intracellular activity of Malondialdehyde (MDA) was measured by TBA method.Two groups were compared by using Student t test.Differences among multiple groups were evaluated by ANOVA.Results Compared with control group,the cell apoptosis of Angiotensin Ⅱ group was increased [(45.46 ± 15.40)％ vs.(1.88 ± 3.28)％,P =0.002],the synthesis of ROS was increased [(9.24 ±0.46) vs.(1.00 ±0.00),P＜0.01],theactivity of Caspase 3 was increased [(35.03 ± 3.54) vs.(13.33 ± 1.79),P ＜ 0.01],the activity of MDA was increased [(4.32 ±0.73) vs.(2.05 ±0.18),P＜0.01)],the phosphorylation of AMPK was decreased,the activity of SOD was decreased [(90.29 ± 14.73) vs.(136.02 ± 18.82),P =0.001];compared with Angiotensin Ⅱ group,the cell apoptosis of Angiotensin Ⅱ + valsartan group and Angiotensin Ⅱ + AICAR group were decreased [(24.91 ±8.46)％ vs.(45.46±15.40)％,P=0.031];[(27.90 ±4.39)％ vs.(45.46 ± 15.40)％,P =0.038],the synthesis of ROS was decreased [(2.37 ±0.05) vs.(9.24±0.46),P＜0.01];[(2.79±0.31) vs.(9.24±0.46),P＜0.01],the activity of Caspase3wasdecreased [(18.08±2.69) vs.(35.03±3.54),P＜0.01];[(27.83±3.56) vs.(35.03 ± 3.54),P =0.002],the activity of MDA were decreased [(3.25 ± 0.55) vs.(4.32 ± 0.73),P=0.017];[(3.46±0.60) vs.(4.32±0.73),P=0.047],the phosphorylationofAMPKwas increased,the activity of SOD was increased [(140.71 ±20.27) vs.(90.29 ± 14.73),P ＜0.01];[(116.73 ± 17.96) vs.(90.29 ± 14.73),P =0.029];compared with Angiotensin Ⅱ + valsarntan group,the cell apoptosis of Angiotensin Ⅱ + valsartan + compound C group was increased [(43.84 ± 12.00) ％ vs.(24.91 ± 8.46)％,P =0.043],the synthesis of ROS was increased [(4.64 ± 0.15) vs.(2.37 ± 0.05),P ＜ 0.01],the activity of Caspase 3 was increased [(25.64 ± 3.52) vs.(18.08 ± 2.69),P=0.011],the activity of MDA was increased [(5.12 ±0.92) vs.(3.25 ±0.55),P＜ 0.01],the phosphorylation of AMPK was decreased,the activity of SOD was decreased [(99.48 ± 16.59) vs.(90.29 ± 14.73),P =0.002)].Conclusions Valsartan could inhibit angiotensin Ⅱ-induced vascular smooth muscle cell apoptosis via activating AMPK,suppressing the synthesis of ROS and the activity of MDA,elevating the activity of SOD.

Acupressure ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Male ; Moxibustion ; Nocturnal Enuresis ; therapy

Objective To investigate whether pulse pressure variation (△PP) reflect the effects of PEEP and fluid resuscitation (FR) on hemodynamic effects.Methods Twenty critical patients with acute lung injury was ventilated with volume control (VT =8 mL/kg,Ti/Te = 1: 2) ,and PaCO2 was kept at 35 to 45 mm Hg.PEEP was setted as 5 cm H2O and 15 cm H2O in randomized order.Hemodynamic parameters including cardiac index, pulse pressure, central venous pressure, etc.were monitered by PiCCO system.Measurements were performed after the application of 5 cm H2O PEEP (PEEPs group)and 15 cm H2O PEEP (PEEP15 group) respectively.When the PEEP-induced decrease in cardiac index (CI) was > 10%, measurements were also performed after fluid resuscitation.Results Compared with PEEPs group, CI was decreased significantly in PEEP15 group(P < 0.05), and APP was increased significantly (P < 0.05).In 14 patients whose PEEP-induced decrease in CI was > 10%, fluid resuscitation increased CI from (3.01±0.57)L · min-1· m-1to (3.62±0.68)L · min-1 · m-2(P<0.01),and decreased △PP from (17±3)% to (10±2) % (P < 0.01).PEEP15-induced decrease in CI was correlated negatively with APP on PEEP5 (r =-0.91,P < 0.01) and with the PEEP15-induced increase in △PP (r =-0.79, P < 0.01).FR-induced changes in CI correlated with APP before FR (r = 0.96, P < 0.01) and with the FR-induced decrease in APP (r =-0.95, P < 0.01).Conclusions In ventilated patients with ALI, △PP may be a simple and useful parameter in predicting and assessing the hemodynamic effects of PEEP and FR.

Objective To study the effect of noninvasive pressure venrilation(NIPPV) on the treatment of acute exacerbarions of chronic obstructive pulmonary disease(COPD) with typeⅡrespiratory failure. Methods 46 cases of COPD were selected to treat with NIPPV in our hospital from 2001 January to 2005 May. The data in arterial blood gas(pH,PaO2,PaCO2),the course of disease in the hospital,the rate of endotracheal intubation, the mortality of the patients in NIPPV were analyzed and compared with those of the patients without NIPPV treatment before. Results The datas in arterial blood gas had been imprived significantly in NIPPV after 24h.The couse of disease in hospital was significantly shkrter,and the rate of endotracheal intubation and mortality of the patients was significantly lower in NIPPV than those in no NIPPV. There was remarkably difference between two groups. In NIPPV, the rate of endotracheal intubation were significantly lower in light and moderate trspiratkry failure than those in severe respiratory failure(P

Aim To assess the effect of heat shock factor-1(HSF1)and heat shock protein 70(HSP70)to tachyphylaxis by bradykinin in the opening blood-tumor barrier(BTB).Methods The C6 rat intracerebral glioma model was constructed by stereotactic implantation technique.Using western blotting method to continue monitoring the protein expression of HSF1 and HSP70 in tumor tissue after bradykinin acted on animals.The expression of occludin in tumor tissue were detected by immunohistochemistry method.Using Evans blue and electron microscope,respectively,detected the permeability and pathology of BTB after intracarotid infusion of bradykinin in C6 rats.Results Bradykinin increased the tight junction opening and the permeability of BTB in C6 animals,and the relative increments of EB were 5.19 ?g?g-1(0 min),5.06 ?g?g-1(5 min),11.35 ?g?g-1(10 min,P

Objective To study the expression of nerve growth factor (NGF) in sensory and motor Schwann cells and its significance in the nerve specific regeneration Method Sensory and motor Schwann cells were prepared in vitro,and each group of cells were cultured in common media and IL 1 media respectively The expression of NGF was measured by Sangwich ELISA Result Generally speaking,the expression level of sensory Schwann cells is higher than that of motor cells And the expression modes of the two types of cells are different,according to the timing and peak numbers Conclusion The NGF expressions of sensory and motor Schwann cells are different,such a difference may partly explain the mechanism of the nerve specific regeneration