Objective To study the effect ofoxymatrine on serum matrix metalloproteinase-9 (MMP-9)and transforming growth factor-β 1 (TGF-β 1) in patients with idiopathic pulmonary fibrosis (IPF) and illuminate the mechanism and action.Methods Total 38 patients with IPF in the patient group were divided into the conventional treatment group and the oxymatrine group by random digits table method with 19 cases each.Meanwhile 38 healthy people were as the control group.Then serum MMP-9 and TGF-β1 levels were detected by enzyme-linked immunosorbent assay and compared.Results The serum MMP-9 level in the control group and the patient group was (92.30 ± 27.21),(420.66 ± 101.78) μg/L,and there was significant difference (P ＜ 0.05).The serum TGF-β 1 level in the control group and the patient group was (67.36 ± 13.03),(217.82 ±43.90) μg/L,there was significant difference (P ＜0.05).There was no significant difference in the serum MMP-9 and TGF-β1 level before treatment between the conventional treatment group and the oxymatrine group (P ＞ 0.05).There was significant difference in the serum MMP-9 level before and after treatment in the conventional treatment group [(138.91 ± 35.09) μ g/L vs.(428.21 ±102.75) μ g/L] (P ＜ 0.05).There was no significant difference in the serum MMP-9 level before and after treatment in the oxymatrine group (P ＞ 0.05).There was significant difference in the serum TGF-β 1 level before and after treatment in the conventional treatment group and the oxymatrine group [(145.42 ± 30.78)μg/Lvs.(200.34±58.96)μg/L;(102.37±26.04) μg/Lvs.(219.78±63.20) μg/L](P＜0.05).There was significant difference in the serum TGF-β1 level after treatment between the conventional treatment group and the oxymatrine group (P＜ 0.05).Conclusion Oxymatrine can degrade IPF by reducing TGF-β 1 and maintaining MMP-9 in the higher level.

OBJECTIVE To investigate the opportunity and method of surgery for removing tracheobronchial foreign bodies. METHODS A retrospective study was carried out among 500 children with tracheobronchial foreign bodies treated in our hospital from June, 2005 to June, 2009. RESULTS The foreign bodies were successfully removed in 4(0.8%) patients with fiberoptic-bronchoscopy, 2(0.4%) patients with thoracotomy, 20(4%)patients with endoscope or rigid bronchoscopy via tracheostomy, 32(6.4%) patients with direct laryngoscopy, 436(87.2%)patients with rigid bronchoscopy . There were 6 patients (1.2%) need another operation to fully remove the foreign bodies. CONCLUSION Proper method should be choose for removing tracheobronchial foreign bodies according to the history, location and kind of the foreign bodies.

Objective To observe the effects of chronic levodopa administration on cerebral dopamine transporter in healthy aged SD rats.Methods Twelve healthy aged SD rats was divided into three groups,which was respectively gavaged with high-dose of levodopa (150 mg/kg), low-dose of levodopa (50mg/kg) and NS everyday for four months. After levodopa was stopped for twenty-four hours, 0.2 ml of 99mTc-TRODAT-1 (800 ?Gi) was injected into the rats through vena caudalis. Three hours later, the rats were sacrificed and the wet weight of striatum, cerebral cortex, cerebella and brain stem was weighed. We measured the counts of radiation and calculated the numerical value of ID.Results The activity of ID in striatum was ( 0.764? 0.129) in high-dose group and ( 0.928? 0.145) in low-dose group. Compared with the control group ( 1.562? 0.289), the differences were significant ( P

Objective To discuss the significance of stress roentgenogram on diagnosis of chronic instability of lateral ankle and. bring forward the radiology diagnosis criteria. Methods 40 patients with chronic instability of lateral ankle and 40 normal people were randomly selected. Bilateral ankles of each subject had two basic roentgenographic measurements named inversion stress anteroposterior roentgenogram and anterior drawer stress radiograph. The talar tilt angel and anterior translation of talus were measured. Results The average TT and ATT of suffered ankles are 9.1 and 7.8mm,while the values of the opposite ankles are 5.4 and 5.4mm, the comparison group are 4.9 and 6.1mm.There is significant difference between the suffered ankles and normal ones(P

Objective To study the clinical effects of different surgical treatments for laryngotracheal steno-sis .Methods The clinical data of 56 patients with laryngotracheal stenosis from July 2006 to July 2014 were ana-lyzed .Of all 56 cases ,7 cases were children ,49 cases were aducts ;9 cases underwent CO2 laser resection ,5 cases underwent temperature controlled radiofrequency ablation and 5 cases received laryngeal mold under self -retaining laryngoscope ,6 cases received Keel placement after laryngofissure ,23 cases received T -shape tube implantation af-ter laryngoplasty or tracheoplasty and 8 cases underwent end-to -end tracheal anastomosis after cervical tracheoto-my .Results All the patients had been followed up for 6 months to 2 years postoperatively .Thirty nine cases of 56 were cured after single-operation ,and 10 of 56 were cured after repeated operations .No one suffered from laryn-gotracheal stenosis again .Five cases failed and survived with tracheal tube .2 cases lost to follow -up .No people die or had complications .Among all cases ,5 cases with laryngeal mold and 8 cases with tracheal anastomosis were cured after single-operation .Among 9 cases with lasere scar removal surgery ,5 cases were cured after an operation ,3 cases were cured after two operations ,1 case failed because of laryngeal cancer recurrence .Among 5 case with tem-perature controlled radiofrequency ablation ,3 cases were cured afrter an operation ,1 case was cured after two opera-tions ,1 case had no effect .Among 6 cases with keel place -ment ,4 cases were cured after one operation ,1 case was cured after two operations ,1 case had no effect .Among 23 cases with T -shape tube implantation ,14 cases were cured after an operstion ,5 cases were cured after two and more operations ,2 cases had no effects and 2 cases were lost .Conclusion In order to improve the therapeutic effects of laryngotracheal stenosis ,the treatment strategy should be personalized according to the degree of stenosis ,the position of stemtis ,and the impairment of laryngotra-cheal framework .

Objective To investigate the effects of extracorporeal membrane oxygenation (ECMO) in severe cardiopaths with crisis. Methods Fourteen cases of severe eardiopaths with crisis were treated by ECMO with V A- ECMO technique, whose pump was centrifugal pump and whose tubes was spread byheparin. The cases included 8 fulminating myocarditis (FM) cases with ventricular arrhythmias or/and acute heart failure or/and cardiac shock and 6 acute myocardial infarction cases with pump failure or cardiac shock,in whom 10 cases with cardiorespiratory resuscitation. Haemodynamics and blood gas analysis, and so on were measured before and after treatment. Results The support time of ECMO was 3-106 h, mean (32.4±27.6) h. After ECMO mean arterial blood pressure (MAP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd), partial pressure of arterial oxygen, saturation of blood oxygen improved (P < 0.05 or < 0.01 ), negative value of base excess decreased significantly( P < 0.01 ). MAP had notchanged before and after stopping ECMO [ (80.02±10.20) wan Hg (1 mm Hg = 0.133 kPa) vs (76.34±9.15) mm Hg] (P > 0.05), however, LVEF and LVEDd improved continually (P <0.05). Conclusion ECMO can provide oxygen supply and stable circulation volume for severe cardiopaths with crisis to recover cardiorespiratory function or save valuable time to treat primary disease.

The antinociceptive effect of epidural administration of huwentoxin-I was elucidated in a tonic visceral pain rat model produced by acute colon inflammation. The nociceptive behaviors were induced by perendoscopically injecting dilute formalin (50 μl) into the depth of the colonic wall in rats. Both ω-conotoxinMVIIA and morphine hydrochloride were given epidurally as positive control while saline as negative control.Similar to ω-conotoxin-MVIIA and hydrochloride morphine, the epidural administration of HWTX-Ⅰ significantly reduced the nociceptive responses in a dose-dependent manner in tonic visceral pain rat model ( P ＜ 0.05). The suppression effects of both huwentoxin- Ⅰ and ω-conotoxin-MVIIA at 20 μg/kg were kept steady compared with the saline group and reached their maximum effects at the doses of 50 ～ 75 μg/kg within 1 hour when the nociception had been observed. It was also found that at the same doses, huwentoxin- Ⅰ was less effective in antinociception than ω-conotoxin-MVIIA. However, ω-conotoxin-MVIIA, but not huwentoxinⅠ , caused an obvious motor dysfunction at these doses. The action of morphine hydrochloride was initiated faster, but lasted for a shorter time than that of huwentoxin- Ⅰ and ω-conotoxin-MVIIA. Thus, huwentoxinⅠ , a potent blocker of neuronal N-type voltage-sensitive calcium channels, induced a remarkable dosedependent restrain effect similar to ω-conotoxin-MVIIA and morphine on the tonic visceral pain produced by colonic wall injection of formalin in conscious rats.

Objective To find out risk factors affecting the prognosis of adult cardiogenic shock patients treated with extracorporeal membrane oxygenation.Methods From January 2003 to December 2010,patients with cardiogenic shock required veno-arterial ECMO after failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied. Patients with severe traumatic brain injury,advanced malignancies and multiple organ failure were excluded.All patients were divided into survival group and death group.The risk factors were found out using one-way ANOVA and a multivariate logistic regression analysis was used to determine independent factors associated with survival.Results Thirty-one patients successfully weaned from ECMO. Twenty-two patients were successfully discharged.The average duration of ECMO was 41.56 ± 43.07 hours.Factors associated with failure of hospital discharge were age,pre-ECMO levels of ejection fraction,pre-ECMO levels of lactate,disseminated intravascular coagulation,renal failure and multiorgan failure (P ＜ 0.05). Conclusions Irreversible heart failure and the complications are significantly correlated with survival,and the early use of ECMO for cardiogenic shock and recognize the factors are key to the success of ECMO treatment.

Objective To investigate the risk factors of ICU delirium in critically ill patients. Methods A total of 1 74 critically ill patients in ICU who were older than 18 yrs and stayed in ICU exceeding 24 hs from January 201 5 to June 201 5 were enrolled.Patients were divided into delirium group and non delirium group.Delirium was assessed twice daily with the Confusion Assessment Method for the ICU (CAM-ICU)during the first 7 days.The factors such as history of alcoholism and other 12 factors were analyzed by univariate and multivariate logistic regression analysis to identify those risk factors associated with delirium.Results With 22 cases of delirium in 1 74 patients,the in-cidence of delirium was 12.64% (delirium group).Variables associated with delirium were coronary heart history,operation,tracheal intubation,clinical use of mechanical ventilation,hypoxemia and Benzodiazepine.Multivariate logistic regression analysis showed that coronary heart disease (OR 3.932,95%CI 1.225-12.61 7),surgery(OR 9.691,95%CI 2.103-44.657),hypoxemia(OR 6.595, 95%CI 1.377-31.585),Benzodiazepine use (OR 7.620,95%CI 1.713-33.899)was independent risk factors of delirium in critically ill patients (P < 0.05 or P < 0.01 ).Conclusion Coronary heart disease,surgery,hypoxemia and Benzodiazepine are independent risk factors of ICU delirium in criti-cally ill patients.Early screening and prevention of delirium should be given to reduce the occurrence of delirium for patients in ICU.

Objective To investigate the effect of the nursing care of critically ill patients in intensive care unit(ICU) with non-invasive ventilation assisted by sedation simultaneously. Methods During the intervention phase from June 2012 to June 2013 of 28 patients in ICU treated by non-invasive ventilation, sedatives were adjusted according to Ramsay Scale, and the parameters of the life signs (heart rate, blood pressure, oxygen saturation,etc) were measured by nurses. Results 89.3%(25/28) patients obtained the improvement of the disease despite of the complications such as over-sedation and instable hemodynamics. Conclusion The key points can increase tolerance of non-invasive ventilation and improve clinical outcomes, develop comprehensive nursing strategies on safety and effectiveness of sedation and non-invasive ventilation .