Objective To observe the effect of penehyclidine hydrochloride (PHCD) combined with mechanical ventilation on inflammatory response in rats with acute respiratory distress syndrome(ARDS)induced by hydrochloric acid(HCl)inhalation. Methods 32 adult healthy male Sprague-Dawley(SD)rats were randomly divided into four groups:sham operation group,ARDS model group,PHCD group(intraperitoneal injection of 0.5 mg/kg PHCD at 30 minutes before HCl instillation)and mechanical ventilation group〔mechanical ventilation was given after PHCD treatment,ventilator settings were as follows:tidal volume(VT)=4 mL/kg,respiratory rate(RR)= 70 beats/min,the time ratio of inspiration to expiration(I:E)=1:2,fraction of inspired oxygen concentration(FiO2)=0.21〕,8 rats in each group. The rat ARDS model was created by HCl(0.1 mol/L,1.2 mL/kg) intratracheal instillation. After mechanical ventilation for 4 hours,the experiment was stopped. Arterial partial pressure of oxygen(PaO2)was measured,and the oxygenation index as well as lung wet/dry weight ratio(W/D)were calculated respectively. The pathological changes in lung tissues were observed under light microscope,and the pathological score was evaluated. The levels of myeloperoxidase(MPO),interlukin-8(IL-8)and nuclear factor-κB (NF-κB)in homogenate of lung tissues were all measured respectively by enzyme linked immunosorbent assay (ELISA). Results In rats of ARDS model group, there were significant infiltration of inflammatory cells, collapse of extensive pulmonary alveoli and hyaline membrane formation in lung tissues,but the edema in pulmonary mesenchymal tissue and congestion of micro vessels were not obvious. Compared with sham operation group,the lung tissue pathological score(9.88±2.03 vs. 1.38±0.92),lung W/D ratio(7.67±0.96 vs. 4.08±0.65)were significantly increased(both P<0.01),while oxygenation index〔mmHg(1 mmHg=0.133 kPa):213±29 vs. 428±28〕was markedly decreased in model group(P<0.01);and the concentrations of MPO(μg/L:34.18±3.99 vs. 20.92±1.40), IL-8(ng/L:864±53 vs. 583±91)and NF-κB(ng/L:1 229±133 vs. 803±130)in homogenate of lung tissues were significantly higher in model group(all P<0.01). The pathological changes in lung tissues including inflammatory cell infiltration,collapse of alveoli and pulmonary edema,etc. were obviously improved when treated by PHCD or mechanical ventilation and the lung pathological score and W/D ratio were significantly decreased compared with those of model group,oxygenation index in these two groups were both significantly increased,meanwhile, the concentrations of MPO,IL-8 and NF-κB were sharply decreased when compared with those of model group (all P<0.05). The degree of improvement in all above indexes were greater in mechanical ventilation group than those in PHCD group(lung injury score:5.63±1.85 vs. 7.63±1.67,lung W/D ratio:5.35±1.05 vs. 6.46±1.17, oxygenation index:325±57 vs. 272±44,MPO:25.80±3.36 vs. 29.88±3.93,IL-8:736±53 vs. 802±53, NF-κB:984±75 vs. 1 109±118,all P<0.05),however they did not reach the levels of the sham operation group (P<0.05 or P<0.01). Conclusion PHCD can inhibit the inflammatory response in ARDS rats induced by HCl inhalation,thus it may protect the lung tissue from injury induced by HCl,and the protective role of PHCD plus menchanical ventilation is superior to that of PHCD only.

Objective To study the effect of breviscapine injection on cerebral blood perfusion in patients with hypoperfusion/decreased embolic clearance type cerebral infarction.Methods 100 patients with hypoperfusion/decreased embolic clearance type cerebral infarction in our hospital were selected and randomly divided into two groups.Both group were treated with conventional western medicines, and the experimental group was additionally treated with breviscapine injection.The plasma D-dimer (D-D), fibrinogen (Fib), systolic and diastolic blood pressure and recovery of neurological function were compared between the two groups.Results D-D and Fib levels and NIHSS score in the experimental group were significantly lower than those in the control group (P< 0.05), while the systolic blood pressure was significantly higher than that in the control group (P< 0.05).Conclusion Breviscapine injection can reduce the plasma D-D and Fib levels, increase cerebral vascular blood flow and improve the neurological function in patients with hypoperfusion/decreased embolic clearance type cerebral infarction.

Objective To explore the criterion of constitution with Yin-deficiency and provide the evidence for further development of establishing the criterion.Method According to reference documents on TCM,a questionnaire on the criterion of constitution with Yin-deficiency was developed and distributed to 51 experts of TCM in Zhejiang province.Results The mean scores of forty-six items ranged from 2.02 to 2.78 and top sixteen symptoms were dry mouth,dry stools,dry throat,feverish palms and soles,thready pulse,constipation,emaciation,yellowish urine,red tongue,rapid pulse,vertigo,thirst with preference for cold drinks,vexation,dry lips,little coating,thirst with frequent drinking.Modes of 46 items ranged from 1 to 4.Coefficients of weight for diagnosis ranged from 0.018 to 0.024 and variance of coefficients were from 0.540 to 1.572.Conclusion Forty-six items could become the content of the criterion of constitution.

Objective To explore the clinical manifestations,antimicrobial therapy,and risk factors of mortality in patients with Acinetobacter baumannii bloodstream infection.Methods Clinical data of 153 patients with Acinetobacter baumannii bloodstream infection hospitalized in First Affiliated Hospital of Zhejiang University from January 2013 to September 2014 were analyzed retrospectively.According to the 28-day survival after diagnosis,the patients were divided into death group (n =76) and survival group (n =77).Data related to demographic and clinical characteristics,underlying diseases,treatment,invasive procedures,bacterial resistance to antibiotics,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)scores at onset,and antimicrobial therapy were collected.The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis.Results This study included 153 patients with Acinetobacter baumannii bloodstream infection.The 28-day mortality was 49.7％.The independent risk factors of mortality were APACHE Ⅱ score ≥22 at onset (OR =15.7,95％ CI 5.1-48.1,P ＜ 0.001),septic shock (OR =6.3,95 ％ CI 1.9-21.3,P =0.003),and administration of steroids (OR =3.6,95％ CI 1.0-12.3,P =0.043).Compared with subjects treated with non-cefoperazone-sulbactam-based regimen,those treated with cefoperazone-sulbactam for multidrug-resistant Acinetobacter baumannii (MDR-AB) had significantly lower mortality on day7,day14 and day28 (8.9％ vs 59.2％,31.1％ vs 65.8％,44.4％ vs 72.4％ respectively).Conclusions The patients with Acinetobacter baumannii bloodstream infection have high mortality within one month.Administration of steroids and septic shock are associated with poor prognosis.APACHE Ⅱ score ≥ 22 at onset predicts adverse outcome.Cefoperazone-sulbactam-based antimicrobial therapy improves patients' survival.

Objective To study effect of the health resources on overall quality of medical students.Methods In three vacations,697 medical students investigated the basic conditions of medical institutions in accordance with the level from low to high and three self-designed questionnaire.Researchers educated the students in accordance with the findings.Results Medical students got to know the basic health resources of China better.They deeply realized the character of medical work,social position,occupational importance,value of professional course,and so on.Conclusion Comprehensive quality of medical students was improved by early clinical practice.

Objective　To explore the relationship of pathological types of lung cancer with sex, age, site, and clinical diagnosis. Methods　The data of 1 310 patients with lung cancer diagnosed with fibrobronchoscopy, was retrospectively analyzed. Results　①The preliminary clinical diagnosed lung cancers which were comfirmed by fibrobronchoscopic biopsy later were mainly small cell lung cancer. ②The percentage of squamous carcinoma was significantly greater in male (78.0%) than in female (49.7%), but the percentage of adenocarcinoma was significantly higher in female (38.1%) than in male (13.1%)(P<0.0001). ③Among the patients with lung cancer, 53.7% was from 40 to 59 years old and 40.2% over 60. The average age of male patients (56.9 years old) was significantly greater than that of female (51.1 years old) (P<0.0001). ④ The average age of patients with squamous carcinoma and adenocarcinoma was greater in male than in female, but that with small cell carcinoma and squamous carcinoma was greater in female than in male. ⑤The percentage of male with lung cancer in the left lung (37.3%) was greater than that of female (26.0%), but the female had lung cancer in the right lung (59.7%) while male had (49.3%). The left and right upper lobe was more (45.4%) in male, but the right upper and lower lobe was more(43.3%) in female. Conclusion　①The fibrobronchoscopic examination is very important in the diagnosis of lung cancer. ②The pathological types and sites of lung cancer is different in different sex and age, which provide the exact bases for medical and surgical treatment for lung cancer.

Objective To investigate the protective effect and associated mechanism of PNS in spinal cord hemisection injury.Methods fifty-five adult SD rats were randomly divided into three groups,sham group(n =5),spinal cord injury group(n =25),PNS group(n =25).The rats were evaluated in behavioral test with BBB score,pathology and immunohistochemistry at 1 d,3d,7d,14d,21d after the procedures.Results Motor recovery was significantly better in PNS group than the spinal cord injury group at 3d,7d,14d and 21d.Nissl staining showed less neuron necrosis and more integrated neural cells in morphology.cPLA2 expression was inhabited in PNS group,and less number of positive cells were found in the group.Conclusion PNS can inhibit the expression of cPLA2 after spinal cord injury,which may be one of the mechanisms of its effect on promoting motor recovery.

BACKGROUND: Disease pathogenic factors are complicated. There is not an effective method to analyze large sample data mining, and application ability of information technology of clinical doctors needs to be improved. OBJECTIVE: Using BP algorithm of artificial neural network to analyze large sample clinical cases, in order to explore inner relations between disease pathogenic factors and diseases.METHODS: Take hypertension for example, medical data of patients with hypertension in a traditional Chinese medical hospital served as experimental data, and the influence factors of the disease were simulated with Microsoft SQL Server 2005 Analysis Services, the mining data was analyzed, and a single query was used as prediction and decision support.RESULTS AND CONCLUSION: Analysis of effect of disease pathogenic factors on disease itself based on artificial neural network with BP algorithm has good predictive effect in clinical diagnosis, which is of benefit to enhance the diagnostic efficiency of medical personnel using information technology.

Objective:To investigate the clinical effects and main pharmacological actions of Pingantongluo Granules (Radix Paeoniae Alba, Rhizoma Gastrodiae, Radix Salviae Miltiorrhizae, Rhizoma Chuanxiong, Concha Haliotidis, etc.) for migraine with liver wind and blood stasis symptom. Methods: Randomized controlled trail, double blind and double dummy method were applied. Yuntongding Tablets was used as a control drug in clinical investigation and Routunding Tablets as a control drug in pharmacological experiment study. Results: The total effective rates of the treatment group and the control group were 95.0% and 83.3% for migraine and 80.0% and 61.6% for the liver wind and blood stasis symptom, respectively. Pinggantongluo Granules began to act on migraine in ( 11.75 ? 6.70 )h, and the control drug did in ( 18.30 ? 8.22 )h. There were a significant difference between two groups ( P

Objective Retrospectively analyzed the data of patients with delayed bleeding after colorectal polypectomy,summarized the risk factors and treatment methods of bleeding patients,and provided the basis for further prevention and treatment of postoperative delayed bleeding.Methods Collected the clinical data of 1 243 patients who were admitted into the department of gastroenterology of third affiliated hospital of the third military medical university and accepted polypectomy with colonoscopy from January 2014 to December 2016.Divided these patients into the bleeding group and the non-bleeding group according to whether there was delayed bleeding after surgery.The age,size of polypus,location of polypus,postoperative pathology of the two groups were compared and the postoperative treatment of bleeding was evaluated.Results Among the 1 243 patients underwent colorectal polypectomy,there were 14 cases of delayed bleeding,and the incidence was 1.13%.In the bleeding group,there was 1 case of secondary delayed bleeding and 2 cases of bloody stool after hemostasis for the delayed bleeding.Delayed bleeding occurred at (4.73±2.49)days after surgery.The predilection site of of polypus was rectum in the bleeding group (7/14,50%), and the diameter of polypus was (16.65±4.91)mm in the bleeding group,which was lager than (8.07±4.23)mm in the non-bleeding group with statistical difference (P<0.05).The proportion of hypertensive and diabetic patients in the bleeding group was significantly higher than that in the non-bleeding group (P<0.05).Juvenile polyps and tubular adenoma with high grade intraepithelial neoplasia were more common in the bleeding group(P<0.05).The bleeding group achieved good hemostatic effect by purse suture,hemostatic clip,electrocautery or injection hemostasis.Conclusion Older age,hypertension and diabetes,lager size of polypus,rectum polypus,juvenile polyps and tubular adenoma with high grade intraepithelial neoplasia were risk factor for delayed bleeding.In the event of delayed bleeding,different choice of purse suture,hemostatic clip,electrocautery or injection hemostasis according to different wounds can achieve the desired effect.