Objective To explore the effect of montelukast combined with budesonide for treating acute bronchial asthma, pulmonary function improvement and to provide the basis for clinical treatment.Methods 192 patients with acute asthma were selected.They were divided into the control group and the observation group according to the admission order and odd and even numbers randomly, 96 patients in each group.The control group was treated with budesonide based on routine treatment, and the observation group was given budesonide formoterol based on the control group.The clinical effect, pulmonary function (forced expiratory volume in one second (FEV1),FEV1/forced vital capacity (FVC) and peak expiratory flow (PEF) the percentage of predicted value index percentage were observed.The daytime and night asthma symptoms and airway reactivity score: early respiratory resistance (Rrsc) and response threshold (Dmin) were assessed.Results The cough disappeared, shortness of breath, wheezing relieving, moist rales disappeared and wheeze disappeared time of the observation group after treatment were (5.92±1.03)d,(3.48±0.71)d,(3.74±0.69)d,(5.32±0.96)d and (5.12±0.77)d, which were lower than those of the control group (t=9.31,7.26,8.11,9.02,8.31,all P<0.05).The daytime and nighttime asthma symptom scores of the observation group after treatment were (0.54±0.31)points and (0.62±0.29)points, which were lower than those of the control group (t=7.90,7.33,all P<0.05).Rrsc score of the observation group after treatment was (2.20±0.56)points, which was lower than that of the control group (t=7.86,P<0.05).The Dmin score of the observation group after treatment was (8.33±0.81)points, which was higher than that of the control group (t=9.15,P<0.05).FEV1,FEV1/FVC and PEF of the two groups after treatment were significantly higher than those before treatment(all P<0.05).FEV1,FEV1/FVC and PEF of the observation group after treatment were (2.95±0.58)L,(71.91±0.69) and (96.45±6.11), which were higher than those of the control group after treatment (t=7.60,9.45,10.21,all P<0.05).Conclusion Montelukast combined with budesonide formoterol in the treatment of acute attack of bronchial asthma has better effect, could significantly reduce the symptoms of asthma patients and shorten the treatment time with synergistic effect, and improve the pulmonary ventilation function of the patients.

OBJECTIVE: To investigate the mechanism of in situ intestinal absorption of mangiferin in rats.METHODS: The in situ intestinal perfusion model was employed.HPLC/UV was developed to determine the concentration of mangiferin in intestinal circulated fluid.The effects of mangiferin concentration,bile and absorption site on the absorption parameters were studied.RESULTS:The mangiferin at a concentration from 5.0 to 25.0 ?g?mL-1 had no influence on the intestinal absorption kinetics(Ka) but it did at a concentration below 12.5 ?g?mL-1 in biliary duct-ligated rats.The absorption rate constants(Ka) in descending order were 0.164 h-1(ileum),0.132 h-1(jejunum),0.125 h-1(colon) and 0.107 h-1(duodenum),respectively.CONCLUSION: The absorption of mangiferin is in line with first-order kinetics with passive diffusion absorption mechanism.Mangiferin is well absorbed at all segments of intestine in rats,and bile is conducive to the increase of the permeability coefficient of Mangiferin in intestine.

China ; Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; Meridians ; Phytotherapy ; Taiwan ; Yin-Yang

Adult ; Death, Sudden ; Humans ; Male ; Middle Aged ; Trichloroethylene ; poisoning

Objective To evaluate the current knowledge and practice of evidence-based nursing for preventing ventilator-associated pneumonia (VAP) and its influencing factors in ICU nurses. Methods Selfadministered structured questionnaire was used in 101 ICU nurses working in one grade three A hospital of Jiangsu province by convenient sampling method. The results underwent statistical description and variance analysis. Results The mean score of knowledge about evidence-based nursing to prevent VAP was (4.75±1.42) (total score=10),the mean score of practice was (3.32±0.32) (total score=4). The influencing factors of knowledge in ICU nurses were different divisions and ICU working years. Different ICU working years resulted in different behavior of nurses. Most nurses considered that nursing work was too busy due to serious condition of patients, which was the principal interfering factor in practice of evidence-based nursing for preventing VAP. Conclusions Further expertise of ventilator-associated pneumonia training and evidence-based nursing education are urgently required. The best-practice guidelines for preventing VAP are more often consummated. Whilst encouraging the reasonable personnel disposition and the essential facilities are priority. Effective fulfillmere in evidence-based practice to prevent VAP may be achieved by broader adjustment of the medical system and the medical cost structure, so that evidence-based nursing for preventing VAP can be put into effect.

Objective To obtain panorama X-ray images of the lower extremity with a simple method,eliminate the mosai-cing error,and apply this manual stitching technique for digital radiography to the measurement of the force line in total knee arthroplasty.Methods The track of X-ray tube was preset,and Dicom format data were collected by using digital X-ray ima-ging.Then,the data were imported to photoshop CS4 for manual image registration and image fusion.The reliability of the film was tested by comparing the vertical length of the body symbols proj ection in the coronal plane with that on the panorama X-ray (AutoCAD 2010)images.Moreover,the hip-knee-ankle angle was compared before and after operation.Results The matching sample t-test showed there were no significant differences in the length(4 groups of data)between the greater trochanter femur and the fibular head,and between the fibular head and the lateral malleolus between before and after operation(P>0.05 for all) .The hip-knee-ankles angle was much greater after operation than that before operation.Conclusion This manual stitching technique for digital radiography can produce seamless and precise panorama X-ray images,which can be used to reflect the length and angle of the lower extremity before and after operation.

Objective:To assess the repeatability ( intraobserver comparison ) and reproducibility ( inter-observer comparison) of two different methods for establishing the occlusal plane on digital dental models. Methods:With Angle’ s classification as a stratification factor,48 cases were randomly extracted from 806 ones which had integrated clinical data and had their orthodontic treatment from July 2004 to August 2008 in Department of Orthodontics,Peking University School and Hospital of Stomatology. Post-treatment plas-ter casts of 48 cases were scanned by Roland LPX-1200 3 D laser scanner to generate geometry data as re-search subjects. In a locally developed software package,one observer repeated 5 times at intervals of at least one week to localize prescriptive landmarks on each digital model to establish a group of functional occlusal planes and a group of anatomic occlusal planes, while 6 observers established two other groups of functional and anatomic occlusal planes independently. Standard deviations of dihedral angles of each group on each model were calculated and compared between the related groups. The models with the five largest standard deviations of each group were studied to explore possible factors that might influence the identification of the landmarks on the digital models. Results:Significant difference of intraobserver varia-bility was not detected between the functional occlusal plane and the anatomic occlusal plane ( P>0 . 1 ) , while that of interobserver variability was detected ( P<0 . 001 ) . The pooled experimental standard devia-tion the 6 observers established for the functional occlusal plane was 0 . 2 ° smaller than that of the anato-mic occlusal plane. The functional occlusal plane’ s variability of intraobserver and interobsever did not differ significantly (P>0. 1),while the anatomic occlusal plane’s variability of the intraobserver was sig-nificantly smaller than that of the interobserver (P<0. 001),with a 0. 12° difference value of the pooled experimental standard deviation. Conclusion: When one observer measures a number of digital models, both the functional and the anatomic occlusal planes are suitable as a conference plane with equal repeatability. When several observers measure a large number of digital models,the functional occlusal plane is more reproducible than the anatomic occlusal plane,but the difference is small.

Objective To investigate the condition of self-management of patient controlled analgesia pump in patients in the ICU.Methods 82 patients in ICU were selected in July 2014 and were randomly divided into the observation group and the control group with 41 cases in each.In the observation group,the PCAP was fixed on the bedrails of patients' bed and controlled by themselves to acquire satisfactory analgesia effect.In the control group,the PCAP was operated by the nurses.Pains scores was compared between the two groups.Results The different position of PCAP showed the different scores of pain in the patients.The pain scores in the observation group (2.93±1.47) was significantly lower than that in the control group (3.76±1.36),P＜0.05.Conclusions Proper position of PCAP and controlled by patients can effectively reduce postoperative pain of patients in the ICU,and then reduce their suffering and improve their comfort.

The outbreaks of Zika virus infection in different regions of the world underscore the potential for the virus to spread further in the Americas and beyond.Zika is a mosquito-borneFlavivirusand is transmitted by Aedes spp. mosquitoes.It is has been reported recently that Zika virus intrauterine infection causes fetal brain abnormality and microcephaly, and WHO encourages pregnant women in countries at risk MUST protecting themselves from mosquito bites. Until now, there is no imported case in China.We have established resource and technology storage to reply to the potentialZika cases in the future, therefore, people do not need to panic in China.

Cardiac arrest (CA) is an acute critical illness with the high occurrence in the world. The directions of cardiopulmonary resuscitation (CPR) development are to improve CA patients' survival rate and to decrease the poor prognosis. β-blockers can selectively block the neurotransmitter or receptor agonists. They offer beneficial pharmacological properties and have been widely used in the treatment of cardiovascular diseases. Based on the search result of the domestic and foreign medical databases, the usage of β-blockers including clinical research, animal experiments and clinical work of CPR patients was summarized. Finally, the CPR research progress of β-blockers in recent years was reviewed in the article.