Objective To explore the clinical application of fiberoptic bronchoscopy with bronchoalveolar lavage(BAL) in patients with mechanical ventilation.Methods Sixty patients with mechanical ventilation were randomly divided into control group ( n =30) and treatment group ( n =30).All patients accepted anti-infection,nutritional support treatments.The patients in the control group accepted routine treatment;others in the treatment group were treated with BAL.The therapeutic effects in the two groups were evaluated and compared.Results The treatment effects in treatment group was better than that in control group( P ＜0.05).The improvement of blood gas analysis in treatment group was better than in control group (P ＜ 0.05 ),the time of mechanical ventilation,length of stay in treatment group were shorter than those in the control group ( P ＜ 0.05 ).The number of success to remove ventilator,organs failure and hospital mortality in treatment group were less than those in the control group ( P ＜ 0.05 ).Conclusion Fiberoptic bronchoscopy with BAL treatment could be safe and effective for patients with mechanical ventilation.It deserves to be popularized.

ObjectiveTo observe the influence of the recombinant human growth hormone (rhGH) on nutritional status and immune function in patients with acute respiratory distress syndrome(ARDS).Methods60 ARDS patients with mechanical ventilation hospitalized in the ICU ward were randomly divided into the treatment group and the control group,each group had 30 cases.The patients of the two groups were given the same treatment program of nutritional support,and the patients of the treatment group were administered with rhGH 8u/d,subcutaneous injection,treatment course was 7d.1d before treatment,4d,7d after treatment,the nutrition indicators and changes in immune parameters of the two groups were detected.ResultsThe nutritional status before treatment and the cellular immune parameters of the two groups were lower than normal.4d after treatment,the transferrin requirements(TFN),prealbumin(PA),CD3,CD4,CD8 and CD4/CD8 ratio of the treatment group increased significantly( all P ＜0.05 ) ;7d after treatment,TFN,PA,CD3,CD4,CD8,CD4/CD8 ratio of the treatment group increased significantly compared with the control group ( P ＜ 0.01 ).ConclusionLow-dose hormone therapy combined with the nutritional support could improve the nutritional status,the immune function of ARDS patients with mechanical ventilation and enhance the success rate of patients in emergency.

To observe the preventive effect of polydatin on diabetic myocardial hypertrophy in mice and discuss its and mechanism. The diabetic model was induced with low dose STZ (40 mg x kg(-1) x d(-1) x 5 d, ip) for five days in mice. The myocardial hypertrophy was determined by hypertrophy indexes (LVHI, left ventricular/right ventricle and septum), left ventricular/body weight (LV/BW), the histological examination and the mRNA expression of atrial natriuretic factor(ANF). The fast blood glucose(FBG), serum insulin and plasma hemoglobin A1c ( HbA1c) levels were detected, and then HOMA insulin resistance index ( HOMA. IR) was calculated. The mRNA and protein expressions were measured by qRT-PCR and western blotting, respectively. According to the results, the FBG of the model group exceeded 11.1 mmol x L(-1), with notable decrease in BW and significant increase in insulin, HbA1c and HOME. IR, suggesting the successful establishment and stability of the diabetic model. The increases in LVHI, LV/BW, cell surface and ANF mRNA indicated a myocardial hypertrophy in diabetic mice. Meanwhile, the model group showed decrease in mRNA and protein expressions of PPARβ and significant increase in NF-κB p65, COX-2 and iNOS expressions. After the preventation with PD (50, 100 mg x kg(-1) x d(-1)), diabetic mice showed increase in BW, reduction in the levels of FBG, insulin and HbA1 c, relief in insulin resistance and significant recovery in hypertrophy indexes, indicating PD has the protective effect in diabetic myocardial hypertrophy. Meanwhile, PD up-regulated the expression of PPARβ, inhibited the expressions of NF-κB p65, COX-2 and iNOS, demonstrating that PD's protective effect may be related to the activation of PPARβ and the inhibition of NF-κB, COX-2 and iNOS signaling pathways.
Animals ; Diabetes Mellitus, Experimental ; complications ; Diabetic Cardiomyopathies ; drug therapy ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Glucosides ; administration & dosage ; Humans ; Hypertrophy ; drug therapy ; genetics ; metabolism ; Insulin ; metabolism ; Male ; Mice ; NF-kappa B ; genetics ; metabolism ; Signal Transduction ; Stilbenes ; administration & dosage

Adult ; Compliance ; Humans ; Male ; Occupational Exposure ; prevention & control ; Population Surveillance ; Quality Control ; Young Adult

In 1989, Fitz defined and classified severe acute pancreatitis (SAP) and he thought that surgical treatment of SAP is feasible. Since then, the strategy of treating SAP was a controversial issue over past decades. Currently, relevant literatures reported that medical or minimally invasive treatments are superior to surgical treatment, while it is too early to make the final conclusion because of the complexity of SAP. From 1989 to 2008, 1852 patients with acute pancreatitis were treated at the General Hospital of PLA, and the clinical data of 18 patients who died of SAP were retrospectively analyzed. Based on the analysis, we concluded that medical conservative therapy and surgical operative therapy should not be opposed to each other. Selecting ideal timing and appropriate operation on the basis of pathological changes of retroperitoneum and pancreatitis should be considered seriously, and the new concept of "miniaturization of trauma" should also be introduced in treating SAP.

Objective To detect the spreading scope of rectal cancer to mesorectum by RT PCR using carcinoembryonic antigen (CEA) mRNA as a marker and to investigate the excision scope of mesorectum in resection of rectal cancer. Methods Forty specimens from 40 rectal cancer patients who underwent curative operation was employed to detect the metastatic deposits scattered in the mesorectum by RT PCR using CEA as a marker. Results Nine of 40 (22.5%) specimens contained metastatic deposits scattered in the mesorectum. The metastasis was just within the range of 4cm mesorectum under the verge of tumor. The tumor spreading to mesorectum is correlated with Dukes stages,the infiltrated depth of bowel wall, tumor differentiation and tumor type( P 0.05). Conclusion The excision of mesorectum should be within the range of 5cm under the verge of tumor in surgical management of rectal cancer.

Objective To evaluate the effectiveness of repeated intravitreal conbercept injection in patients with macular edema (ME) of retinal vein occlusion (RVO),guided by optic coherence tomography (OCT).Methods It is a retrospective case study.Forty patients (40 eyes) diagnosed as ME secondary to RVO were enrolled in this study.There were 19 males (19 eyes) and 21 females (21 eyes),with the mean age of (53.58 ± 13.19) years and the mean course of 1.5 months.The best corrected visual acuity (BCVA),indirect ophthalmoscopy,fundus fluorescein angiography (FFA) and OCT were performed.The mean baseline of BCVA,central macular thickness (CMT) were 0.25 ± 0.18 and (509.48 ± 170.13) μm respectively.All the patients were treated with 10.00 mg/ml conbercept 0.05 ml (including conbercept 0.5 mg).Follow-up of these patients was 1 to 6 months after treatments,the BCVA,fundus manifestations,OCT were retrospectively observed by every month,the FFA was retrospectively observed by every 3 months.When there was retinal edema or CMT ≥ 50 μm by OCT during follow-up,those patients were retreated with intravitreal conbercept injection.The changes of the BCVA,CMT were evaluated before and after treatment.Meanwhile,complications in eyes related to medicine and treatment methods were evaluated too.Results At the 6 months,the BCVA was improved (increase≥2 lines) in 25 eyes (62.50％),stabilized (± 1 line) in 13 eyes (32.50％) and decreased 2 lines in 2 eyes (5.00％).Retinal hemorrhage and exudates were absorbed in most patients.FFA showed no fluorescein leakage in 1 1 eyes (27.50％),minor fluorescein leakage in 26 eyes (65.00％),and retinal capillary non-perfusion in 3 eyes (7.50％).OCT showed absorption of the subretinal fluid.The mean CMT were (235.20± 100.44) μm at 6 months.Intravitreal injection of conbercept was applied for 4 times in 8 eyes (20.00％),3 times for 18 eyes (45.00％),and 2 times for 14 eyes (35.00％).The mean number of intravitreal injection was 2.85 times.There were no ocular or systemic adverse events observed in all patients.Conclusion Intravitreal conbercept injection is an efficacy and safe treatment for the patients with ME of RVO guided by OCT.It can stabilize and improve the visual acuity.

Objective To study the effect of ischemia reperfusion(IR) on electrophysiological function of sinoatrial node(SAN) in rabbits. Methods Ninety healthy adult rabbits were divided randomly into control group, ischemia groups (I) 10(I10 min), 30(I30 min), 60(I60 min) and 120 min(I120 min) and IR groups (10, 30, 60 and 120 min ischemia followed by 4 h reperfusion respectively)(I10 minR4 h, I30 minR4 h, I60 minR4 h and I120 minR4 h). There were 10 rabbits in the control group and each subgroup. IR injury model of SAN was established by occluding and loosening the start section of right coronary artery(RCA). The changes of AA interval and arrhythmia were recorded by electrocardiography and cardiac chamber electrography synchronously. Results ① There was no significant difference in AA interval between different time points in the control group. ② Sinus arrest(SA), sinus bradycardia with arrhythmia(SB), or atrial tachyarrhythmia(AT) were found in 51 rabbits (63.75%) out of 80 rabbits in I and IR groups in ischemic period. The incidence rate of arrhythmia increased in a time dependent manner. The AA intervals also increased by at least 40 ms in 54 rabbits (67.5%). ③ Sinus or atrial arrhythmia during ischemic period was found in 26 out of the 40 rabbits in IR group, but 15 returned normal after reperfusion. ④ Increased AA intervals were found in 27 out of the 40 rabbits in IR group during ischemic period. Most of them recovered to pre occlusion level within 10 min after reperfusion, but the AA intervals prolonged again in I60 minR4 h and I120 minR4 h groups as the reperfusion elongated. Conclusion ① These findings suggest that about 2/3 of the rabbit sinus node arteries may stem from right coronary artery. ② Electrophysiological changes due to ischemia of SAN resemble the electrocardiogram of sick sinoatrial node syndrome. ③ Reperfusion arrhythmia can be induced by reperfusion after a long time of ischemia.

Objective To evaluate the usefulness of speckle tracking imaging(STI) for assessment of left ventricular(LV) and right ventricular (RV) functions in patients with isolated disease of right coronary artery.Methods 45 cases were diagnosed as single right coronary lesions given echocardiography,30 cases had chest pain but coronary angiography had not seen the obvious narrow as a comparison.The twodimensional loop-cinec were obtained in apical 4-chamber view,apical 2-chamber view and long axis of LV view.Eighteen segments of LV longitudinal peak systolic strain,global peak systolic strain of each view and three segments of RV free wall were measured by two-dimensional strain software.Results In the patients who had right coronary lesions but did not happen myocardial infarction,the strain(S) values in the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid segment of RV free wall was lower( P ＜0.05).In the patients who had right coronary lesions and myocardial infarction,the S values in the base,mid segmental of LV antsept,the apex segmental of LV anterior wall,the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid and apex segments of RV free wall were lower ( P ＜0.05).And the LV global longitudinal strains were lower in the two groups (P ＜0.05).Conclusions STI is a new and useful technology for assessment ventricular functions in patients with isolated disease of right coronary artery,and there are multiple segments impaired.

Adult ; Female ; Humans ; Hyperlipoproteinemia Type III ; pathology ; Male ; Middle Aged ; Nephrosis, Lipoid ; pathology