Objective To evaluate the excursion of the diaphragm and analyze the value in predicting weaning from mechanical ventilation in intensive care unit patients.Methods The patients with mechanical ventilation (＞48 hours) in ICU at Hebei Forth Medical University Hospital from June 2014 to December were classified into a success group or a failure group according to the weaning outcome.T-piece spontaneous breathing (SBT),airway occlusion pressure at 0.1 sec (P0.1) and maximal inspiratory pressure (MIP),rapid shallow breathing index (RSBI) and P0.1/MIP were measured or calculated.During the period of the 1 st hour SBT,the excursion of diaphragm was measured with ultrasonography.The predictive value of each parameter to weaning was evaluated with ROC curve.Results A total of 98 patients were enrolled in this study,including 74 successfully weaning and 24 failed.There were significant differences between two groups (success group and failure group) in P0.1 [(2.00 ± 2.00) cmH2O (1 cmH2O =0.098 kPa) vs (3.00 ±2.75)cmH2O,P ＜0.05],RSBI (39.14 ± 16.81 vs 52.00 ± 19.18,P ＜0.05),left diaphragmatic excursion [(1.12 ± 0.97) cm vs (0.69 ± 1.00) cm,P ＜ 0.001],right diaphragmatic excursion(1.87 ± 0.75) cm vs (1.17 ± 0.76) cm,P ＜ 0.001] and mean value of left and right diaphragmatic excursion [(1.57 ± 0.52) cm vs (0.83 ± 0.53) cm,and P ＜ 0.001].The ventilation time [2.00 (2.00-4.00) d vs 4.00 (2.00-5.00) d],ICU hospital lengths of stay [4.50 (3.00-7.25) d vs 8.50 (6.25-15.25) d] and total hospital lengths of stay [20.00 (15.00-25.25) d vs 25.00 (20.25-37.25)d] were also statistically significant in success group and failure group respectively (all P ＜ 0.05).The cutoff value of diaphragmatic excursion for predicting successful extubation was determined to be 1.14 cm by ROC curve analysis.The sensitivity of diaphragmatic excursion to predict successful weaning was 89.2％ and the specificity was 75.0％,the AUCROC was 0.849.Conclusion As an early predictor of diaphragmatic dysfunction,diaphragmatic excursion is probably superior to the traditional parameters in predicting weaning from ventilator in ICU patients.

Objective To explore the effects of fibroblast transdifferentiation for myofibroblast (MFB) in the pathogenesis of systemic sclerosis (SSc) and to explore the antifibrotic mechanism of interferon γ (IFN-γ) in SSc.Methods The fibroblasts derived from the skin lesions of SSc patients and healthy adult controls were cultured in vitro and the MFB proportion in fibroblasts was examined by qualitative and quantitative α-smooth muscle actin (α-SMA) detection.By adding IFN-γ to the culture system with several doses,the influence on fibroblast proliferation and transdifferentiation for MFB in SSc was observed with MTT and enzyme linked immunosorbent assay (ELISA) respectively.Differences in the means of two independent samples were tested by Student' t-test.The means among multiple independent samples were com-pared by ANOVA.Results The means of positive α-SMA in SSc fibroblasts were higher than those in the controls (P＜0.01).With extended culture time,α-SMA levels of the two groups all increased gradually (P＜ 0.01 all),but there were higher α-SMA levels in SSc fibroblasts (24 h:130±19,48 h:183±21,72 h:249± 22) than those in controls (24 h:98±21,48 h:143±16,72 h:174±19) (P＜0.05 all).Although fibroblast proliferation and α-SMA levels were not influenced after adding of IFN-γ 10 U/ml (P＞0.05 all),but IFN-γ at concentration of 100 U/ml and 1000 U/ml could obviously repress fibroblast proliferation and α-SMA levels (P＜0.05 all),and 1000 U/ml had the strongest inhibiting effect at 24,48,72 h.Conclusion The fibroblasts in the skin of SSc patients have a strong potency to transdifferentiate to MFB.Early appropviate dose of IFN-γ could repress fibroblast proliferation and transdifferentiation in SSc.

As a result of observation in lab. ,it showed that the rice straw attracted snail well,it at-tracted uninfected and infected snails, and adult and young snails respectively without singnificant difference. On this basis,we can investigate the snails under water by rice straw curtains during water raising season. This paper reported that the method for weaving rice straw curtain fixed by stone,and using foamed plastics as buoy were easy and convenient. The rate of snail-attraction was highest when it took 14 hours ,especially in August.

OBJECTIVE:To study the bioequivalence of 2 kinds of Losartan potassium tablets in healthy volunteers. METHODS: A single oral dose of test tablet 100 mg and reference tablet 100 mg were given to 20 healthy volunteers in randomized crossover study. The plasma concentrations of losartan and its metabolite EXP3174 were determined by LC-MS. The pharmacokinetic parameters were calculated and bioequivalence of 2 kinds of tablets was evaluated. RESULTS: Main pharmacokinetic parameters of Losartan of test tablets vs. reference tablets were as follows: Cmax(534.230?238.642) ng?mL-1 vs.(520.020?226.800) ng?mL-1; tmax(1.401?0.946)h vs.(1.334?0.750)h; AUC0～36(871.177?232.315) ng?h?mL-1 vs. (773.030?252.209) ng?h?mL-1; pharmacokinetic parameters of metabolite EXP3174 of test tablets vs. reference tablets were as follows: Cmax (1 294.000?387.815) ng?mL-1 vs.(1 140.900?317.615)ng?mL-1;tmax(2.667?1.144)h vs.(2.734?1.162)h;AUC0～36(6 267.905?1 350.300)ng?h?mL-1 vs.(5 719.411?1 127.725) ng?h?mL-1; AUC0～∞(6 316.605?1 343.048)ng?h?mL-1 vs. (5 755.335?1 138.358) ng?h?mL-1. The relative bioavailability of test tablet was (116.6?24.3)%. CONCLUSION: 2 kinds of Losartan potassium tablets are bioequivalent.

Non-coding RNA refers to a class of RNAs that cannot encode proteins, and they play a very important role in regulating cellular activities. Pulmonary arteryhypertension is a group of diseases characterized by progressive elevation of pulmonary vascular pressure. Its pathogenesis is complex and its influencing factors are numerous. The study found that non-coding RNA, as a transcription product that does not participate in translational functions, plays an important role in the pathogenesis of patients with pulmonary arteryhypertension. With regard to the more well-studied and relatively mature circRNAs, lncRNAs, and miRNAs in non-coding RNAs, this article review the pathophysiological processes involved in the formation of pulmonary arteryhypertension.

This study is to determine the preventive effect and mechanism of targeting IL-17A on pulmonary inflammation and fibrosis after acute lung injury. Mice were treated with anti-IL-17A antibody on the day 7 and sacrificed on the day 14 after bleomycin lung injury. The pulmonary inflammatory status and the deposition of collagen were measured by HE and Sirius stains staining. The contents of hydroxyproline and collagen were measured by using commercial kits. The survival rate of mice was calculated by Kaplan-Meier methods. The inflammatory cytokines in bronchoalveolar lavage fluid were measured by ELISA and the expressions of inflammation-related molecules were detected by Western blotting assay. Targeting of IL-17A could prevent the development of lung inflammation, decrease collagen deposition and the contents of hydroxyproline, and protect against the development of pulmonary fibrosis, which together led to an increase in the animal survival. Moreover, blocking IL-17A decreased the expression ofpro-fibrotic cytokines such as IL-17A, TGF-beta1 and IL-13; increased the expression of anti-fibrotic or anti-inflammatory factors such as IFN-gamma, COX-2, 5-LOX, 15-LOX. Indeed, IL-17A antagonism suppressed the activation of pro-inflammatory p65NF-kappaB but enhanced the activation of pro-resolving p50NF-kappaB. In conclusion, that blockade of IL-17A prevents the development of pulmonary fibrosis from acute lung injury, is because blocking IL-17A may prevent acute inflammation converting to chronic inflammation.

Objective To evaluate the effectiveness of nurse-led discharge planning for hospital inpatients with chronic disease.Methods The Cochrane Library,PubMed,Medline,EMBASE,Chinese Biomedical Literature Database Database(CBM),China National Kmowledge Infrastructure (CNKI),VIP Chinese full text database (VIP) and Wanfang Data were searched for randomized controlled trials assessing nurse-directed discharge planning for hospital inpatients with chronic disease.Two reviewers independently extracted data and assessed risk of bias.Meta-analysis was conducted for the eligible studies by RevMan 5.3.4.Results Seventeen randomized controlled trials and 5 331 participants were included.Meta-analysis demonstrated that,compared to standard care,nurse-led discharge planning were effective in reducing hospital readmission [risk radio (RR)=0.73,95％ confidence interval (CI) 0.64-0.84,P＜0.01],duration of inpatient readmissions [mean difference (MD)=-2.48,95％CI-3.68--1.29,P＜0.01],and all-cause mortality (RR=0.78,95％CI 0.62-0.97,P＜ 0.05).However,no reduction in the length of stay of the index admission (MD=-0.18,95％CI-0.64-0.27,P ＞ 0.05) was demonstrated.Conclusions Nurse-led discharge planning has a positive impact on several aspects of care for hospital inpatients with chronic disease,including reducing readmission,readmission length of stay,and all-cause mortality.It is worth being popularized.

Objective: To identify the relationship between the expression of protein tyrosine phosphatase non-receptor type 12 (PTPN12) and radiotherapy effect in non-small cell lung cancer (NSCLC) tissues and to determine whether PTPN12 deficiency can sensi-tize lung cancer cells to irradiation. Methods: From September 2013 to October 2014, 92 NSCLC patients undergoing radiotherapy with or without platinum-based combination chemotherapy were analyzed retrospectively. Before the treatment, PTPN12 expression was detected through immunohistochemistry. After the completion of radiotherapy, the patients' responses were assessed and radio-therapeutic efficacy analyzed. The human NSCLC cell line H1299 was infected with shPTPN12 knockdown, and colony survival assay was analyzed after irradiation. Chi-square test was used to examine the correlation between PTPN12 expression and clinicopathologi-cal characteristics. Univariate analyses and Logistic regression test were used to analyze the relationship between clinicopathological characteristics and radiotherapeutic response. Results: Patients with low PTPN12 expression were more sensitive to radiotherapy than those with high PTPN12 expression (80.0%vs. 57.1%, P=0.018). Multivariate analysis showed that PTPN12 expression was the on-ly independent predictor of radiotherapeutic response in NSCLC. The H1299-shPTPN12-knockdown cells were sensitive to irradiation. Conclusions:The results of the study indicated that downregulation of PTPN12 improved the radiosensitivity of NSCLC cells.

BACKGROUND:Numerous studies have focused on the clinical efficacy of alogeneic bone graft and humeral head replacement for the treatment of proximal humeral fractures, but their comparative studies are rarely reported. OBJECTIVE:To investigate the effect of alogeneic bone grafting in the treatment of proximal humeral fractures in the high risk group. METHODS:Clinical data of 120 cases of proximal humeral fractures aged≥ 60 years were retrospectively analyzed. Sixty of the 120 cases underwent alogeneic bone grafting combined with locking plate fixation as experimental group, and the other 60 cases were subjected to semi-shoulder joint replacement as control group. Al patients were folowed up for 8-24 months. Fracture healing, colodiaphyseal angle, humeral head height and shoulder joint function were observed and measured. RESULTS AND CONCLUSION:During the postoperative 8-24 months, al the fractures were healed by first intention, and there were no rejection reactions, large/smal nodules, humeral head displacement, necrosis, and screw loosening. Loss of the humeral head height at the last folow-up and the active flexion angle of the shoulder at postoperative 12 weeks were significantly higher in the experimental group than the control group (P < 0.05). Scores on forearm, shoulder and hand dysfunction were significantly lower in the experimental group than the control group (P < 0.05). However, no significant difference was observed in the colodiaphyseal angle and SF-36 scores between the two groups. These finding indicate that alogeneic bone grafting can strength the internal fixation of proximal humeral fractures in the high-risk group, and improve patient’s upper limb function.

Objective To investigate the effect of radiotherapy combined with interventional therapy on the changes of vascular endothelial growth factor (VEGF) in patients with advanced cervical cancer.Methods 62 cases of cervical cancer collected in the first people’s hospital of jingzhou city during January 2009 to February 2014 were randomly divided into two groups.The patients in group A were treated with radiotherapy, and the patients in group B were treated with radiotherapy combined with interventional therapy.The level of vascular endothelial growth factor in two groups after treatment was measured by enzyme-linked immunoassay.Results The level of vascular endothelial growth factor of group A was ( 241.77 ±85.86 )μg/L, significantly higher than ( 124.66 ±65.86 )μg/L of group B.The level of vascular endothelial growth factor was related with cervical deterioration degree, tumor stage and lymph nodes metastasis (P<0.05),not with the patient’s age, and the size of the tumors.The level of vascular endothelial growth can reflect the clinical efficacy of patients after therapy (P<0.05).Conclusion Vascular endothelial growth factor level has a close relationship with the degree of deterioration of cervical cancer, tumor staging, lymph node metastasis and the curative effect after the interventional therapy.