Home respiratory support for patients in the home care setting can range from simple oxygen supplementation, non-invasive ventilation, to home ventilation support via a tracheostomy. A home care doctor may not be able to know everything about ventilator support, but he should be familiar with the medical care of patients requiring one, and know who to refer to should patients require ventilator adjustments or troubleshooting. The management of such patients is challenging outside the hospital setting and usually requires a multidisciplinary team effort from the doctors, nurses, medical social worker, respiratory therapists, vendor of the ventilator and, most importantly, dedicated and well-trained caregivers. This article will cover two other important topics that Family Physicians should know when managing patients who require home respiratory support: home oxygen therapy and tracheostomy care.

Background The measurement of corneal Q value is essential for corneal refractive surgery and calculation of intraocular lens during cataract surgery.Topolyzer was often used for the measurement of Q value,and recently Topcon KR-1W and iTrace were applied in ophthalmology.However,whether the measured values are interchangeable is unclear.Objective This study was to assess the difference and consistency of corneal Q values measured by Topcon KR-1W,iTrace and Topolyzer.Methods Corneal Q values were measured on 100 right eyes of 100 healthy subjects under the approval of Ethic Committee of the Sixth Hospital Affiliated to Shanghai Jiaotong University and informed consent of each subject from November to December in 2014 with Topcon KR-1W,iTrace and Topolyzer.Three valid measurements were obtained for each device,and the average values from each device were calculated.The difference of the outcomes among the instruments was compared by repeated measures analysis of variance (ANOVA),and the consistency among the outcomes from different apparatus was analyzed by Bland-Altman plots.Results The mean corneal Q values were-0.184-±0.112,-0.117±0.167 and-0.269±0.117 from Topcon KR-1W,iTrace and Topolyzer,respectively,with a significant difference among them (P ＜ 0.001).The measured Q value by Topcon KR-1W was 0.085±0.010 larger than that by Topolyzer,and the Q values by iTrace was 0.152± 0.014 larger than that by Topolyzer,while the Q values obtained by Topcon KR-1W was 0.067±0.016 smaller than that by iTrace (all at P＜0.05).The 95％ confidence interval of the values between Topcon KR-1W and iTrace,Topcon KR-1W and Topolyzer,iTrace and Topolyzer were-0.106 to-0.028,0.060 to 0.109 and 0.118 to 0.186,respectively.Bland-Altman plots showed that 6％,6％ and 5％ values were outside of 95％ agreement of limit (LoA) between Topcon KR-1W and iTrace,iTrace and Topolyzer or KR-1W and Topolyzer,respectively,with the maximal differences of 0.28,0.43 and 0.38.Conclusions Corneal Q values measured by Topcon KR-1W and iTrace are larger than those measured by Topolyzer.Due to the poor agreements among the corneal Q values by the 3 kinds of devices,they are not interchangeable in clinical applications for the measurement of corneal Q value.

0.05).The activity of Na~+-K~+ ATPase in SMO group was significantly higher than that in HTK group at 72 h(P

All kinds of traditional Chinese medicines (TCMs) differed from each other with different chemical components and properties. Owing to poor conditions and technologies, and the lack of scientific preservation, most TCMs will easily become mouldy during the processes of growth, harvest, handling, translation and especially storage, which will not only influence the quality, safety and efficacy of TCMs, but also cause serious waste and economic losses, and even do great harm to human health. The process of storage is closely related to the qualities of TCMs with many interference factors. Therefore, scientific preservation of TCM during storage is crucial to prevent them from being mouldy. This review analyzed the important harm of mouldy TCMs, summarized the internal and external factors of resulting in TCMs to become mouldy. Based on the above discussion, together with the characteristics and limitations of current TCM preservation techniques, we prospect novel, scientific and reasonable preservation techniques, expecting to provide references for scientific preservation of TCMs to avoid becoming mouldy and guarantee their qualities.
Drug Contamination ; prevention & control ; Drug Storage ; methods ; Drugs, Chinese Herbal ; chemistry ; Fungi ; growth & development ; isolation & purification ; Plants, Medicinal ; chemistry ; microbiology

Objective To explore the possible effect of Nogo-A receptor antagonist NEP1-40 on neurite outgrowth in neonatal rats with hypoxic-ischemic brain damage(HIBD).Methods Sixty-four healthy Wistar rats were randomly divided into 8 groups at 2 different time points(6 h,24 h):control group,HIBD group,NEP1-40 group and ganglioside group(GM-1 group).Rats of control group and HIBD group were injected with saline(0.25 mL/kg)by intraperitoneal injection,while rats of NEP1-40 group and GM-1 group were administrated with 10 mg/(kg?d) NEP1-40 and 20 mg/(kg?d) GM-1 on request in each group,respectively.Immunohistochemical staining was adopted to detect the Nogo-A-positive cells,and ultrastructural changes of neuron and axon were observed by transmission electron microscopy.SPSS 13.0 statistical software was used to run One-Way ANOVA tests on the data presented.Results The Nogo-A-positive cells at 2 time points in rats of HIBD group were significantly higher than those of control group(t=7.63,15.13 Pa0.05),while the Nogo-A-positive cells in GM-1 group at 24 h was lower than that of HIBD group(t=4.25 P

Cytometric bead array (CBA) is a new analytical technique, which can achieve real-time and rapid detection of targeted components in a small amount of sample. With many advantages of high throughput screening, high specificity and sensitivity, low cost, easy operation and good repeatability, this CBA technique has been widely used for the detection of various components in foods, agricultural products and environmental samples. Recently, it has got significant development in rapid detection of small molecules. This review briefly introduced the theory of CBA technique, summarized the application in the analysis of small molecules, such as mycotoxins, pesticide residues, shellfish toxins, and then prospected the application of trace small molecules detection in the complex matrices of traditional Chinese medicine and the development trend of it.
Drug Contamination ; High-Throughput Screening Assays ; instrumentation ; methods ; Immunoassay ; instrumentation ; methods ; Microspheres ; Pesticides ; analysis ; Toxins, Biological ; analysis

Breast Neoplasms ; genetics ; Disease Susceptibility ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; Humans ; Mutation ; Ovarian Neoplasms ; genetics

Adenocarcinoma ; metabolism ; pathology ; Chromogranin A ; metabolism ; Colonic Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; methods ; Proliferating Cell Nuclear Antigen ; metabolism ; Staining and Labeling ; methods ; Vimentin ; metabolism

Objective: To investigate the efifcacy of supplemental walking training in patients with coronary artery disease (CAD) combining heart failure (HF) under routine medication.
Methods: A total of 80 patients with CAD combining HF were randomly divided into 2 groups: Exercise group,n=40 including 25 male and 15 female at (61.2 ± 9.8) years of age, the patients received additional six-minute walking exercise training based on routine medication and Control group,n=40 including 26 male and 14 female at (58.1 ± 10.9) years of age, the patients received routine medication. All patients were treated for 3 months. Plasma levels of BNP and general conditions at before and after the treatment were compared between 2 groups.
Results:①After 3 months treatment, both groups had signiifcantly improved LVESD, LVEDD, LVEF, plasma levels of BNP and six-minute walk test (except LVESD and LVEDD in Control group), allP<0.05.②Compared with Control group, Exercise group showed obviously improved LVEF, plasma level of BNP and six-minute walk test, allP<0.05.
Conclusion: Walking training may increase the exercise tolerance, which is beneifcial to recover the cardiac function in patients with CAD combining HF in addition to routine medication .

Objective To observe prospectively the role of endoscopic diagnosis and treatment of biliary leakages in patients with liver transplantation, and the incidence of bile duct stricture after healing of the leakage. Methods Six eases of T-tube leakage and seven cases of anastomosis leakage complicating liver transplantation were enrolled in this prospective study. Six patients treated by endoscopic plastic stent placement , 2 by naso-biliary catheter drainage, 2 by papillosphincterotomy and 3 by naso-biliary catheter drainage combined with plastic stent placement. Some patients received growth hormone treatment. Results The bile leak resolution time was between 10-35 days in 10 patients with complete document. The median time of leak resolution was 15. 3 days. Four cases of anastomosis stricture, three cases of common hepatic duct and one ease of multiple bile duct stenosis were observed by followed-up nasobiliary catheter cholangiography or ER-CP. Conclusion Endoscopic nasobiliary catheter or plastic stent placement is a safe and effective treatment for bile duct stricture occurred after bile leak resolution in most of liver transplantation patients. Naso-biliary catheter combined with plastic stent placement maybe the best choice for treating bile leak, because, theoretically, it may prevent serious condition happened at accidental nasobiliary catheter dislocation, and it may have prophylactic effect on upcoming bile duct stricture and should be further confirmed.