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Objecfive To investigate the association between bacteriology of airway secretions in acute onset chronic respiratory failure (ACRF) and its clinical prognosis.Methods The bacterial flora and antibiotic resistance in the airway secretions from 44 patients with 49 cases of ACRF were studied,the associations between bacteriology,antibiotic resistance and annual ACRF hospital admission frequency (ACRF≥2 or ACRF<2),its mortality were also explored.Results Positive rate of culture in airway secretions was 63.3%.Untraditional pathogens such as Pseudomonas Aeruginosa accounted for 80.7%.The bacterial yield of patients with ACRF≥2 was twice as that with ACRF<2 (P<0.01).Of the identified bacteria,61.3% displayed antibioticresistance,and there was signifi-cant prolongation of ventilation and hospitalization and increase of mortality in patients with antibiotic resistance(P<0.05).Conclusion There is a predominance of untraditional pathogens such as Pseudomonas Aeruginosa in bacteria from airway secretions of ACRF patients,positive yield and percentage of untraditional pathogens increased with the severity of chronic respiratory failure,infections caused by antibiotic-resistant strains led to higher mortality in ACRF.

group A by turns. (3) The concentrations of plasma endothelin-1 (ET-1) and angiotensin converting enzyme (ACE) were significantly higher in group B than that in group A. However, the ET-1 and ACE were significantly lower in group C than those in group B. (4) The ET-1 and ACE had a significant positive correlation with R/L+S, mPAP and PI, respectively. The multivariate linear regression analysis revealed that ET-1 and ACE were major factor affecting PI. CONCLUSION: The pulmonary vascular and myocardial structural remodeling are one of the pathogenesis accompanied with excessive cell proliferation in hypoxic pulmonary hypertension (PH). Cilazapril effectively prevents and treats the hypoxic PH by inhibiting cell proliferation and structural remodeling of pulmonary circulation, as induced by ET-1 and ACE.

AIM: To study the effect of cilazapril on pulmonary vascular endothelial dysfunction in hypoxic rats. METHODS: The structure and function of endothelium in hypoxic rats were studied by biochemical analysis, radioimmunoassay, transmission electron microscope and correlated with hemodynamic. RESULTS: 1) The change and damage of ultrastructure in endothelial cell (EC) were obsevered in hypoxic rats. 2) The contents of plasma nitric oxide (NO) and superoxide dismutase (SOD) activity in blood as well as endothelial nitric oxide synthase (eNOS) activity in the lung tissue were significantly lower in the hypoxic rat than those in contral animals. The concentrations of plasma endothelin-1(ET-1) and angiotensin converting enzyme(ACE) as well as malondialdehyde(MDA) were significantly higher in the hypoxic rat than these in contral animals. The relaxing and contracting factors had a significant positive/negative correlation with mean pulmonary artery pressure (mPAP). 3) Cilazapril significantly decreased the level of ET-1 and ACE and significantly increased the level of NO and activity of eNOS and SOD. At the same time, cilazapril extenuated hypoxia-induced injuries of EC. CONCLUSION: The results indicate that damaging structure and dysfunction of EC existes in hypoxic rats. The cilazapril effectively preventes and treates the chronic hypoxic PH by relieving the injury and improving secretion in EC.