Objective To investigate the effects of serum brain natriuretic peptide(BNP), procalcitonin (PCT) and lung function by tiotropium bromide combined with aminophylline in the treatment of senile chronic obstructive pulmonary disease.Methods A total of 82 cases of elderly patients with chronic obstructive pulmonary disease ( COPD) were collected and randomly divided into experimental group and control group with 41 cases in each group.Patients in the control group were treated by conventional treatment; patients in the experimental group were treated on the basis of the control group with tiotropium bromide combined with aminophylline.The lung function, respiratory condition and serum levels of PCT, BNP before and after treatment were determined, and the clinical efficacy and safety was compared.Results The effective rate of the control group (68.29%) was lower than the experimental group (87.80%) , with statistical significance ( P<0.05 ); compared with the control group after treatment, the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1%pre of the experimental group significantly increased, dyspnea score decreased, 4 min walking test increased, serum PCT and BNP levels decreased in the experimental group, with statistical significance ( P<0.05 ). Conclusion Tiotropium bromide combined with aminophylline in the treatment of senile chronic obstructive pulmonary disease could reduce the serum BNP and PCT levels and improve lung function.

Objective To evaluate the levels of high-sensitivity-CRP(hs-CRP),interleukin-10(IL-10) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods Fifty cases with obstructive sleep apnea-hypopnea syndrome from Jul.2012 to Dec.2013 in the People's Hospital of Pudong New Area were selected as our subjects,of which,22 patients were with mild-moderate OSAHS and 28 patients were with severe OSA.Twenty-seven health people were served as control group.The levels of hs-CRP,IL-10 were measured.Information of sleep study and other clinical characteristics were collected.Results There were no significant differences in terms of age,hip circumference and waist-to-hipratio (WHR) among three groups (P ＞0.05).Body mass index (BMI),neck circumference,waist circumference,Apnea-Hypopnea Index (AHI),the lowest arterial oxygen saturation(SaO2％) and hs-CRP in mild,severe OSA and control group were (28.01 ±3.41),(28.55±2.87) and (5.51±3.28) kg/m2,(41.18±4.37),(41.46±3.32) and (38.76±2.66) cm,(101.86±8.05),(102.32±7.97) and (94.56±10.25) cm,(44.55±16.26),(10.54±7.08) and (2.02 ±1.51) time/h,(85.05±6.40)％,(72.85±15.07)％,(88.59±3.43)％,(8.35±2.71),(9.19±2.85),(7.06 ± 1.30) mg/L,and the differences were significant(P＜0.05).In patients with OSA,SaO2％ was related to BMI (r =-0.274,P =0.027) and AHI (r =-0.651,P ＜ 0.001).Level of hs-CRP was associated with AHI (r =0.336,P =0.006) and BMI (r =0.247,P =0.047),and weakly associated with IL-10 concentrations.Conclusion Levels of hs-CRP is an important inflammation marker of OSAHS severity.However,levels of IL-10 shows an increasing in mild-moderate OSA patients,then decreasing in patients with severe OSA.

BACKGROUND: As a result of immature brain of children and their imperfect blood brain barrier, improper clinical treatment would affect growth and development of children. It is fully important to perform further investigation on immature brain injury induced neurodegeneration.OBJECTIVE: To observe the ultramicrostructure of neurons in homolateral parietal cortex and hippocampus in newborn 7-day SD rat with contusion of parietal cortex.DESIGN: Completely randomized controlled trial.SETTING: Laboratories of Nerve Morphology and Cytobiology, Medical College of Shanghai Jiaotong University; Electron Microscope Room of Institute for Physiology, Chinese Academy of Science.MATERIALS: The experiment was performed in Teaching and Research Section of Anatomy, Laboratories of Nerve Morphology and Cytobiology ofShanghai Second Medical University (Medical College of Shanghai Jiaotong University; Electron Microscope Room of Institute for Physiology of Chinese Academy of Science from October 2002 to June 2003. A total of 19newborn 7-day SD rats were randomly divided into experimental group, operation control group and normal control group with 15, 2 and 2 in each group respectively.METHODS: In experimental group, free-fall device for brain injury was used for establishing model of contusion of parietal cortex in newborn 7-day SD rat. Anesthesia and scalp incision were conducted, without using free-fall device in operation control group. But above procedures were not carried out in normal control group. The changes of ultramicrostructure were observed under transmission electron microscope after routine treatment of electron microscopic samples.MAIN OUTCOME MEASURES: Ultramicrostructure of neurons in homolateral parietal cortex and hippocampus.RESULTS: All the 19 rats entered results analysis. ① There were two sorts of morphological changes in neurons in experimental group. One was evident swelling of dendrites and bodies of neurons, accompanied with the changes of organelles. In the early stage, expansion of endoplasmic reticulum cisterna could be observed and mitochondria became compact and concentrated. Then, vacuolization of endoplasmic reticulum, progressive swelling and vacuolization of mitochondria, dissociation of polysomes from rough endoplasmic reticulum and scattering of them in cytoplasm could be seen. Changes of nucleolus presented after significant changes of cytoplasm. Nuclear chromatin clustered together under karyotheca and arranged as clockface, which were some masses with irregular contours gathering to the center. Axons were almost normal. The other was concentration of cytoplasm and nucleolus with vacuolizations of unequal size in cytoplasm. ②There was no abnormal change in neurons in homolateral parietal cortex and hippocampus both in operation control group and normal control group.CONCLUSION: Swelling of brain cell and concentration of cytoplasm and nucleolus after brain injury play important roles in brain injury-induced neurodegeneration of immature rats.

OBJECTIVE:To explore the effect of Compound pueraria tablets on the kidney tissues of diabetic nephropathy rats. METHODS:High sugar and lipid diet combined with intraperitoneal injection of streptozotocin were used to establish the model of diabetic nephropathy (DN). Normal control group was established. Model rats were randomly divided into model control group, positive control group(Irbesartan tablet),Compound pueraria tablets low-dose,medium-dose and high-dose [0.102,0.203,0.406 g/(kg·d)] groups(n were 8-10). The corresponding drugs were given,and fasting blood glucose(FBG)and 24 h urinary protein (Upro) were collected at 1st,14th,28th,42nd,56th day after treatment. SCr,BUN,TC,TG and KI were detected,and renal pathology was observed after the last dose. RESULTS:Compared with normal group,FBG of those groups were all increased after modeling,and 24 h Upro of them were all increased after 28th day (P<0.05 or P<0.01). Compared with model control group, FBG of Compound pueraria tablets medium-dose and high-dose groups were all decreased since 42nd day (P<0.05 or P<0.01), and 24 h Upro of Compound pueraria tablets groups were all decreased since 28th day(P<0.05 or P<0.01);BUN,TC,TG and KI of Compound pueraria tablets in medium-dose and high-dose groups were all decreased significantly,and SCr of 3 dose groups were all increased (P<0.05 or P<0.01). The morphological structure of renal cells was improved significantly in drug treatment groups. CONCLUSIONS:Compound pueraria tablets can correct lipid metabolism disorder,reduce Upro and improve renal func-tion,indicating certain protective effect on the kidney tissues of diabetic nephropathy rats.

OBJECTIVE:To study the effect of Compound pueraria tablets on osteoporosis model rats induced by retinoic acid. METHODS:The osteoporosis model was induced by intragastric administration of retinoic acid solution for 15 days;normal group was established. After modeling,the rats were randomly divided into model control group,Xianling gubao capsule [0.32 g/(kg·d)] positive control group,Compound pueraria tablets low-dose and high-dose [0.24,0.4 g/(kg·d)] groups (n=8). After 6 weeks of ig,the serum sample was collected to determine the levels of serum calcium(s-Ca),serum phosphorus(s-P),ALP and bone gla protein (BGP);bone density instrument was used to detect the contents of bone mineral density (BMD),bone mineral content (BMC),bone image area (BIA) and muscle content (MC);the results of compact bone substance scanning were observed. RE-SULTS:Compared with normal group,the levels of s-Ca,BMD,BMC and MC in rats were decreased in model control group, while the level of BGP was increased(P<0.05 or P<0.01). Compared with model control group,related index and compact bone substance scanning of Compound pueraria tablets groups were all improved;the levels of s-Ca,s-P,ALP,BMD and MC were in-creased in Compound pueraria tablets high-dose group,while the level of BGP was decreased;the levels of BMD and MC were in-creased significantly in Compound pueraria tablets low-dose group(P<0.05 or P<0.01). CONCLUSIONS:Compound pueraria tab-lets can improve the osteoporosis induced by retinoic acid in rats.

OBJECTIVE:To establish the method for simultaneous determinations of rutin,forsythin and platycodin D in Sangju ganmao pills.METHODS:HPLC-MS method was adopted.The determination was performed on Waters Atlantis C18 column with mobile phase consisted of acetonitrile-0.1％ formic acid (gradient elution) at the flow rate of 0.2 mL/min.The column temperature was set 35 ℃,and sample size was 10 μL.The ionization mode was electrospray ion,and the reaction mode was multi-reaction monitoring.By positive ion detection mode,the drying gas and nebuliser gas were all high purity nitrogen.The drying gas temperature was 270 ℃.The drying gas flow rate was 25 L/min.The sheath gas flow rate was 10 L/min.The capillary voltage was 4 500 V.The nozzle voltage was 2 000 V and the scanning time was 0.1 s.RESULTS:The linear range of rutin,forsythin and platycodin D were 0.010 82-2.164 μg/mL (r=0.999 7),0.010 18-2.036 μg/mL (r=0.999 4),0.010 27-2.054 μg/mL (r=0.999 7),respectively The limits of quantification were 1.250,0.260,2.720 ng/mL,and the limits of detection were 0.380,0.078,0.820 ng/mL.RSDs of precision,stability and reproducibility tests were all no more than 3.0％.The recoveries were 97.88％-99.88％ (RSD=0.72％,n=6),98.48％-103.13％ (RSD=1.91％,n=6),98.79％-101.41％ (RSD=1.05％,n=6).CONCLUSIONS:This method is simple,precise,stable and reproducible,and can be used for simultaneous determination of rutin,forsythin and platycodin D in Sangju ganmao pills.

Objective To study changes of serum inflammatory indicators,plasma and urine free amino acid of patients with chronic obstructive pulmonary disease.Methods A total of 62 patients with chronic obstructive pulmonary disease in our hospital from June 2014 to April 2016 were selected as observation group,62 healthy with physical examination in our hospital during the same time were selected as control group,the serum inflammatory indicators,plasma and urine free amino acid of two groups were compared,and the above indicators of observation group with different GOLD classifications and stages were compared too.Results The serum inflammatory indicators of observation group were all higher,and plasma free amino acid indicators were all lower than that of control group,and the seruminflammatory indicators and plasma free amino acid indicators of observation group with different GOLD classifications and stages showed significant differences (P ＜ 0.05),while the urine free amino acid indicators of two groups had no significant differences (P ＞ 0.05).Conclusion The change of serum inflammatory indicators and plasma free amino acid of patients with chronic obstructive pulmonary disease are obvious,and the influence of severity degree and disease stages for the expression are greater,while the urine free amino acid have no obvious fluctuation,so the detection value of serum inflammatory indicators and plasma free amino acid of patients with chronic obstructive pulmonary disease are higher.

Objective To study changes of serum inflammatory indicators,plasma and urine free amino acid of patients with chronic obstructive pulmonary disease.Methods A total of 62 patients with chronic obstructive pulmonary disease in our hospital from June 2014 to April 2016 were selected as observation group,62 healthy with physical examination in our hospital during the same time were selected as control group,the serum inflammatory indicators,plasma and urine free amino acid of two groups were compared,and the above indicators of observation group with different GOLD classifications and stages were compared too.Results The serum inflammatory indicators of observation group were all higher,and plasma free amino acid indicators were all lower than that of control group,and the seruminflammatory indicators and plasma free amino acid indicators of observation group with different GOLD classifications and stages showed significant differences (P ＜ 0.05),while the urine free amino acid indicators of two groups had no significant differences (P ＞ 0.05).Conclusion The change of serum inflammatory indicators and plasma free amino acid of patients with chronic obstructive pulmonary disease are obvious,and the influence of severity degree and disease stages for the expression are greater,while the urine free amino acid have no obvious fluctuation,so the detection value of serum inflammatory indicators and plasma free amino acid of patients with chronic obstructive pulmonary disease are higher.

Objective To observe the effects of Banxia Xiexin Decoction on intestinal microbes and 5-HT in ulcerative colitis(UC)model mice induced by drinking sodium dextran sulfate(DSS),and to analyze the mechanism of Banxia Xiexin Decoction in treating UC from the perspective of brain-gut axis.Methods 40 male C57BL6/J mice were randomly divided into control group,model group,positive drug(mesalazine)group and Banxia Xiexin decoction group.All mice except control group were induced by 2.5%DSS solution for 7 days to establish UC model.From the 8th day,mice in the above groups were given intragastric administration of sterilized water,mesalazine aqueous solution and Banxia Xiexin decoction aqueous solution.HE staining was used to observe histopathological changes of colon,ELISA to detect 5-HT content in serum,colon and brain tissues,and 16S rRNA sequencing to further detect the changes of fecal flora in model mice.Results Compared with model group,DAI index of experimental mice model group was significantly decreased after Banxia Xiexin Decoction intervention(P<0.05);IL-2,IL-4 and IFN-γ were significantly recovered(P<0.05).The histopathological score of proximal and distal colon was significantly decreased(P<0.01).Moreover,the peripheral 5-HT level was significantly decreased(P<0.05),but the central had an increasing trend.Results of intestinal flora showed that the relative abundance of Clostridium_sensu_stricto_1,unclassified_p__Firmicutes increased(P<0.05),while Lachnospiraceae_NK4A136_group,Lachnoclostridium,norank_f__Oscillospiraceae and Eubacterium_xylanophilum_group decreased(P<0.05).It was also found that there were significant correlations between intestinal microflora and peripheral and central 5-HT levels.Conclusion Banxia Xiexin Decoction could play a role in treating ulcerative colitis by improving the intestinal microbial composition structure of UC mice to reduce peripheral 5-HT levels and increase central 5-HT levels,thereby improving intestinal inflammatory response and relieving anxiety.

Objective:To explore the status quo of the readiness of evidence-based nursing practice for the maintenance and removal of children's central venous catheter (CVC) in 6 domestic medical institutions Pediatric Intensive Care Unit (PICU), analyze the obstacles faced by the application of CVC maintenance and removal evidence in PICU, so as to provide basis for formulating reform strategies.Methods:This study was a cross-sectional survey. In December 2019, 169 nurses from PICU of 6 medical institutions in Shanghai, Guangzhou, Shenzhen, Hangzhou, Xiamen and Hefei were selected by convenience sampling for investigation. The General Information Questionnaire and Clinic Readiness to Evidence-based Nursing Assessment (CREBNA) were used to evaluate the readiness of clinical nurses to evidence, organizational environment and promoting factors in the process of evidence-based practice. A total of 169 questionnaires were issued, and 169 valid questionnaires were recovered, with a valid recovery rate of 100%.Results:A total of 169 nurses were investigated in 6 evidence application sites. The total score of the multi center CREBNA was (136.96±15.33), which was 88.36% of the full score. The scores of the three dimensions were as follows: organizational environment (40.31±4.45), evidence dimension (53.43±6.14), and promoting factors (43.22±5.81). Four of the last five items in the score ranking were from the promoting factor, and the low score items in four places were all from the promoting factor.Conclusions:The best practice project of children's CVC maintenance in PICU is feasible. However, there are still some deficiencies in the preparation of various evidence application sites, especially in the promoting factors, which should be constantly improved to further promote and maintain the implementation of change.