Objective To explore the role of IL-3,IL-5 and IL-8 in the genesis and development of nasal polypus(NP) by testing IL-3 ,IL-5 and IL-8 Value in Nasal polypus issue. Methods 50 cases of nasal polyps and 30 casesof normal middle turbinate mucosa were involved in this study. Concentrations of IL-3, IL-5 and IL-8 were determined by enzyme linked immunosorbent assay(ELISA). Results The levels of IL-3 ,IL-5 and IL-8 in Nasal polypus issue were significantly higher than that in control group( P ＜ 0.05 ). Conclusion The levels of IL-3, IL-5 and IL-8 in Nasal polypus issue rised,They likely played a certain role in the genesis and development of NP.

Objective To observe the clinical efficacy of Shenqi Fuzheng injection combined with TC regimen in the treatment of advanced epithelial ovarian cancer.Methods A total of 56 patients with advanced epithelial ovarian cancer were divided into treatment group and control group by random digits table method with 28 cases each.In treatment group,the patients received TC regimen (paclitaxel plus carboplatin) chemotherapy,while giving patients Shenqi Fuzheng injection in the process of chemotherapy.In control group,the patients only received TC regimen chemotherapy.Tcell subsets and NK cell changes,changes in the quality of life,the recent efficacy and toxicity were observed in two groups.Results CD3+,CD4+,CD4+/CD8+ and NK cell levels after treatment(0.6924 ± 0.0114,0.3738 ± 0.0234,1.48 ± 2.09,0.1849 ± 0.0210) were higher and CD8+ level (0.2528 ± 0.0112) was lower than those before treatment (0.6415 ± 0.0422,0.3254 ± 0.0312,1.02 ± 1.18,0.1378 ± 0.0126,0.3197 ± 0.0265 ) in treatment group (P ＜ 0.05).Compared with control group (0.6167 ± 0.0347,0.3125 ± 0.0334,1.01 ± 3.31,0.1241 ± 0.0324,0.3101 ± 0.0101 ),CD3+,CD4+,CD4+/CD8+,NK cell levels were increased and CD8+ was decreased in treatment group (P ＜ 0.05).The quality of life improvement in treatment group [60.7％ (17/28)] was higher than that in control group [32.1％ (9/28)] (P ＜ 0.05 ).There was no significant difference in the objective effective power between two groups [89.3 ％ (25/28) vs.82.1％ (23/28)] (P ＞ 0.05 ).The incidence of more than degree Ⅱ marrow depression (leucocyte decreasing,anemia,platelet decreasing) in treatment group was lower than that in control group [32.1％(9/28) vs.71.4％(20/28),25.0％(7/28) vs.42.9％(12/28),17.9％(5/28) vs.35.7％ (10/28)] (P ＜ 0.05).Conclusion Shenqi Fuzheng injection combined with TC regimen in the treatment of advanced epithelial ovarian cancer is safe and effective,it plays an important role in improving immune function,the quality of life and protecting bone marrow function of patients with advanced epithelial ovarian cancer.

Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; drug therapy ; Humans ; Phytotherapy

The physicians and nurses in the intensive care unit often discuss about withdrawing or withholding life-support therapy of critical ill patients with them or their family members.In this article,we expatiate on the importance,approach,agendas and medical ethical issues of the communication about end-of-life care between clinicians and families.

Objective To investigate the causes and therapeutic method for children with obstructive sleep apnea hypopnea syndrome. Methods 72 patients with obstructive sleep apnea hypopnea syndrome were treated by adenctonsillectomy, operation and precaution of postoperation complication. Results 62 patients (86.1% )were cure.8 patients(11.1% ) were better. 2 patients(2.7% ) were no change. Conclusion The children with obstructive sleep apnea hypopnea syndrome caused by glandular organ and hypertrophyoftonsil, can improve the surgical results and late results.

Objective To compare the renal effects of dopamine and dobutamine in patients with sepsis.Methods 90 patients with sepsis were admitted to this study.After resuscitation,each patient was randomly given different vasoactive agent.The changes in urine output,fractional excretion of sodium(FeNa),and creatinine clearance(CCr)were observed.Results The urine output and FeNa in dopamine group were increased significantly as compared with control group and dobutamine group[(3072±480),(2038±515)and(362±522)ml/24h,(3.80±1.09),(2.06±1.14)and(2.10±0.95)%](P＜0.05).Compared with control group and dopamine group,CCr increased significantly in dobutamine group[(79.2±39.1),(50.6±21.8)and(47.4±16.7)ml/min](P＜0.05).Conclusion Dopamine infusion markedly elevates urine output and FeNa,but has no effect on CCr.Dobutamine treatment misht significantly increase CCr,but has no effect on urine output.

Objective　Influence of the function of coagulation and anticoagulation in the elderly patients with thrombotic diseases by activated protein C resistance(APCR) was studied. 　Methods　 Prothrombin fragments 1 and 2 (F1+2),fibrinopeptide A (FPA)，soluble fibrin monomer complex(SFMC) were examined by enzyme linked immunoassay(ELISA); fibrinogen(FIB),antithrombin III antigen(AT-Ⅲ:Ag) and its activity(AT-Ⅲ:A), protein C antigen(PC:Ag) and its activity(PC:A) and APCR were determined using CA 530 blood coagulation analyzer. 　Results　 Compared the elderly patient group with thrombotic diseases with the healthy elderly group, the parameters of coagulation system were obviously increased 〔F1+2(5.4±0.6)nmol/L vs (2.6±1.3)nmol/L,FPA (6.9±1.9)μg/L vs (4.8±2.3)μg/L,SFMC (72.4±8.7)g/L, vs (56.3±11.7)g/L,FIB (5.18±0.68)g/L　vs (3.82±0.74)g/L〕 and that of the anticoagulation system was significantly decreased〔AT-Ⅲ:Ag (212±19)mg/L vs (255±26)mg/L，PC:Ag (63.5±9.2)mg/L vs (82.7±20.1)mg/L〕.The above parameters changed more obviously in the elderly patients with positive APCR than those elderly patients with normal APCR.　Conclusions　APCR accelerated the activation of coagulation system and led to the weakening of the anticoagulation system function in the elderly patients with thrombotic diseases. The positive APCR may be one of the risk factors in the elderly patients who suffered from thrombosis.

Objective To retrospectively analyze risk factor and outcome of VAP after treatment.Methods To retrospectively analyze the incidence of VAP in 249 patients accepted mechanical ventilation.Results Logistic regression analysis shew that age,APACHE Ⅱ scores,the time of mechanical ventilation,gastric acid secretion inhibitor therapy,conscious disturbance,combinations of antibiotics,stomach catheter insertion were associated risk factors for ventilator-associated pneumonia.A total of 91 pathogenic bacterium were identified.G pathogenic bacteriums accounted for 80.2% and G~+ pathogenic bacteriums accounted for 18.6% and true fungus accounted for 1.2%.Multidrug resistance was in most pathogenic bacteriums.All patients were treated with sensitive antibiotics and 39 cases were cured(63.9 %)and 22 cases were dead(36.1 %)after 2-6 weeks treatment.Conclusion Existence of risk factors of VAP are correlated with risk factor and G-pathogenic bacteriums are major pathogenic bacteriums and common drug resisitant microorganisma lead to bad outcome.

Objective To learn the present acceptance of patients from outside Tianjin by local hospitals, for improving the management of their medical services.Methods A study of the hospitals′ network system identified 5 306 inpatients from other places in 2016 as evidenced by their hospital settlement account, with analysis of the patient flow from other places by the hospitals surveyed.Medical workers of eight medical institutions which signed the online settlement contract for non-local patients were subject to questionnaire survey.Results Of the 876 respondents,the number of patients willing to receive non-local insured patients accounted for 78.08%.Non-local patients aged 60 or above accounted for 82.31% among the total non-local patients, of whom 48.55% selected hospitals with national key disciplines, and 30.53% chose those with municipal key disciplines.Conclusions An analysis is required for the demand of non-local patients in terms of the social background and population characteristics.Based on such, non-local patient population needs a better management while those with irrational needs should be discouraged with rules and regulations.

Objective:To evaluate the clinical value of combined detection of ischemia modified albumin(IMA), N-terminal pro brain natriuretic peptide(NT-proBNP) and dynamicelectrocardiogram(DEG) in the diagnosis of silent myocardial ischemia.Methods: IMA, NT-proBNP and DEG of 114 patients with silent myocardial ischemia who were suspected coronary heart disease were detected, and then these results were compared and analyzed with the results of coronary angiography(CAG).Results: In 114 patients with suspected coronary heart disease, 68 cases(59.65％)were positive as the results of CAG. And there were 60 cases were positive as the results of IMA detection, and the specificity and sensitivity of IMA compared with CAG were 82.61％ and 88.24％, respectively. There were 63 cases were positive as the results of NT-proBNP, and the specificity and sensitivity of NT-proBNP compared with CAG were 80.43％ and 92.64％, respectively. There were 57 cases were positive as the results of DEG, and the specificity and sensitivity of DEG compared with CAG were 86.96％ and 83.82％, respectively. While there were 66 cases were positive as the combined detection of the three methods, and specificity and sensitivity of the combined detection compared with CAG were 95.65％ and 97.06％, respectively. Therefore, the specificity and sensitivity of combined detection were significantly higher than that of alone detection of IMA, NT-proBNP and DEG (F=140.637,F=255.467,P<0.05).Conclusion: The comprehensive analysis for the combined detections of IMA, NT-proBNP and DEG can increase both of the specificity and sensitivity of diagnosis, and it can be used as a important screening method for earlier finding silent myocardial.