Objective To investigate the effect of noninvasive positive pressure ventilation NIPPV in treatment of chronic obstructive pulmonary disease with acute exacerbation of respiratory failure. Methods From April 2014 to January 2015, 80 patients with chronic obstructive pulmonary disease and acute exacerbation of respiratory failure in our hospital were enrolled in this study. The patients received anti-infectious, antispasmodic, expectorant, correct electrolyte imbalance and symptomatic and supportive cure. BiPAP Symchrony ventilator was applied in the patients in the treatment group, and low flow nasal catheter ventilation therapy was given to patients in the control group. The following parameters were observed and compared: (1)The clinical efficacy of two groups of patients; (2) RR, PaO2, PaCO2, pH changes of patients before and at 2, 24 hours after ventilation therapy. (3) Intubation and mechanical ventilation, mortality, average length of stay and complications that occur during treatment. Results After treatment, the total effective rate of patients in the treatment group was significantly higher than that of patients in the control group (P < 0.05). At the end of treatment, RR, PaO2, PaCO2, pH changes, aeration at 2 h, 24 h post ventilation of patients in the treatment group improved significantly (P<0.05). The intubation and mechanical ventilation rate, mean hospital stay of patients in the treatment group were significantly shorter than theose of patients in the control group (P<0.05). Conclusion To patients with chronic obstructive pulmonary disease and acute exacerbation of respiratory failure, NIPPV can improve clinical outcomes, improve the patient′s oxygen partial pressure and oxygen saturation, shorter hospital stays, inhibit the rates of mechanical ventilation.

Objective To screen the potent permeation enhancers used in transcutaneous immunization with inactivated highly pathogenic avian influenza vaccine. Methods Five different permeation enhancers, ethanol, propylene glycol, dimethyl sulfoxide, ratinoic acid, oleic acid, were used to treat the skin of BALB/c mice before transcutaneous immunization. Sera were collected before the flist transcutaneous immunization and every two weeks post immunization. The titers of influenza virus-specific humoral IgG and IgA were assayed in serum, lung and nasal lavages by ELISA. The titers of hemagglutination inhibition ( HAI), IFN-γand IL-4 produced by splenic lymphocytes were also detected. Except that, clinical symptom of the skin in different time points and skin pathological changes were observed. Results The serum IgG titers, HAI titers and the influenza virus-specific lgA and IgG in lung and nasal lavages in the groups of HA +CT + DMSO, HA + CT + RA and HA + CT + OA were significantly higher than those of HA and HA + CT groups( P ＜0.05). Moreover, the numbers of splenic lymphocytes producing IFN-γ and IL-4 were increased in the above three groups than those in control groups. In addition, no evident clinical symptoms were observed, but stratum corneum of the skin in different groups showed different changes. Conclusion DMSO,RA and OA are potent permeation enhancers in mouse model inoculated with inactivated high pathogenic avian influenza vaccine transcutaneously.

Objective To study the factors effecting on flow cytometric sperm chromatin structure assay.Methods The SCSA explores the metachromatic properties of acridine orange (AO) and flow cytometry to monitor the susceptibility of sperm chromatin DNA to acid induced denaturation in situ because of the low pH treatment. Results COMP?t, ?t, SD?t value were different upon on the storage methods (①sperm was preserved in 4℃, ②sperm was cryopreservated after dilution ③sperm was cryopreservated). Results show that the second method above made the least artificial injury to sperm DNA. It did not affect the results if the samples were quickly thawed in a 37℃ water bath and detected immediately and the detect current velocity was lower than 300 cell/sec. The intra -CV was 7 28% and the internal CV was 8 92%. Mean and standard deviations of COMP?t were 8 7?11 0% in 511 healthy men. Because data present right skew distribution, the reference range of COMP?t is

AIM: To observe effect of Diyu Shengbai Tablet on preventive treatment for interferon-induced leu-kopenia. METHODS: One hundred and twelve patients with chronic hepatitis B treated by IFN were randomly as-signed into two groups, and they were respectively treated with Diyu Shengbai Tablet and Leucogen for 7 days before treatment by IFN. The leukocyte count of each group was done in 3 days,7 days, 10 days, 14 days,28 days after treatment by IFN. Comparison was made on the value of leukocytes between two preventive treatment groups. RE-SULTS: In the third day after treatment by IFN the value of ANC were(1.91±0.56)×10~9/L, (1.48±0.55)× 10~9/L respectively. The value of leukocytes were (3.91±0.33)×10~9/L, (3.16±0.49)×10~9/L respectively. They had the statistical difference (P<0.05). CONCLUSION: Diyu Shengbai Tablet has an effect on preventing lekopenia induced by IFN, and it is a safe, cheap and convenient drug to treat leucopenia by IFN.

ObjectiveTo explore the relationship of postoperative systemic inflammatory response syndrome(SIRS) and preoperative midway through the urine and perioperative renal pelvis urine of percutaneous nephrostolithotomy(PCNL).Methods Participants included 450 patients with urinary calculus who underwent PCNL,preoperative midway through the urine and perioperative renal pelvis urine of PCNL was collected.ResultsOf 450 cases,preoperative midway through the urine germiculture positive 100 cases (22.2％,100/450 ),perioperative renal pelvis urine germiculture positive 85 cases (18.9％,85/450),46 cases ( 10.2％,46/450) occurred SIRS after PCNL.Decompression of perioperative renal pelvis urine germiculture positive 20 cases(23.5％,20/85) preoperative midway through the urine germiculture positive,perioperative renal pelvis urine the bacteria cultures negative 80 cases (21.9％,80/365 ) preoperative midway through the urine germiculture positive(P ＞0.05),preoperative midway through the urine germiculture positive 15 cases ( 15.0％,15/100) in SIRS,preoperative midway through the urine the bacteria cultures negative 31 cases ( 8.9％,31 /350) in SIRS (P ＞ 0.05 ).Decompression of perioperative renal pelvis urine germiculture positive 18 cases (21.2％,18/85) in SIRS,perioperative renal pelvis urine the bacteria cultures negative 28 cases (7.7％,28/365) in SIRS (P ＜ 0.05 ).ConclusionPreoperative midway through the urine has no correlation with the occurrence of SIRS,perioperative renal pelvis urine germiculture positive can predict the occurrence of SIRS,giving corresponding antibiotic treatment can improve the security of PCNL.

Objective To investigate the instant clinical efficacy of intra-arterial infusion of fasudil combined with routine anti-vasospasm for symptomatic cerebral vasospasm (SCVS). Methods The clinical data of 21 patients with subarachnoid hemorrhage (SAH) due to ruptured aneurysm, who were admitted to authors' hospital during the period from May 2010 and February 2014, were retrospectively analyzed. The lesions included Fisher gradeⅡ(n=2), gradeⅢ (n=16) and gradeⅣ (n=3). Endovascular embolization of the aneurysm was carried out within 48 hours after the confirmation of the diagnosis with total cerebral DSA;no bleeding occurred during the operation and routine anti-vasospasm therapy was given. Within 4-9 days after the onset of the disease, all 21 patients presented SCVS. Half dose systemic heparinization, superselective intra-arterial infusion of fasudil (30 mg fasudil+250 ml saline, lasting for 30 min) were adopted. Reexamination of angiography performed at 15 min after fasudil infusion was employed, and the results were evaluated with NIHSS score by comparing the preoperative findings. Results Imaging examination performed after the treatment showed that significant improvement was obtained in 15 patients and no obvious changes in 6 patients. Clinical symptoms were remarkably improved in 11 patients, partially improved in 4 patients and remained unchanged in 6 patients. The mean NIHSS score was improved from preoperative 28.6 to postoperative 21.2. Conclusion For the treatment of symptomatic cerebral vasospasm, superselective intra-arterial infusion of fasudil is effective and safe, and it has good clinical application value.

The establishment of a scientific salary system is a key measure to improve the incentive and re-straint mechanisms, adjust and optimize the relations of the production, release the reform “bonus”, and is also an important health care reform today. In order to establish a scientific salary system of medical personnel adapting to the health industry characteristics, the paper makes an investigation on the salary level in the years of 2010—2012 in Shanghai, and analyzes the main problems of the present performance pay policy. On this basis, starting from the point of the health industry characteristics, the paper builds the salary system of medical personnel containing the comprehensive budget management, theoretical workload for approval, authorized personnel, performance appraisal and distribution, structural proportion within the industry, fund distribution management through the establishment of the salary level’s average wage and social linkage mechanism, and builds a theoretical framework on salary system of medical personnel in Shanghai.

Objective To investigate protective activity against Aβ25-35-induced cytotoxicity in PC12 cells of different extracts and ursolic acid, which were isolated from pyrola decorata. Methods Aβ25-35-induced cytotoxicity in PC12 cells was established as the model in vitro. The cultured PC12 cells were divided into blank control group, DMSO control group, model control group, different extract groups of pyrola decorate and ursolic acid(UA) group. The different extract groups included ether extract (PE), acetidin extract (AE), n-butanol extract (BE), the water extract (WE), 50% ethanol extract (HEE). MTT assay was used to test the optimum concentration, and the number of viable cells in culture medium was measured by ELISA at 490 nm wavelength. Results The cell viabilities in different extracts groups(PE, AE, BE, WE, HEE) were respectively 89.3%, 77.2%, 79. 2%, 75. 1% ,74. 0% at the concentration of 5. 0 mg ? mL-1 . Moreover, ursolic acid showed the best neuroprotective activity (88.9%) at the concentration of 500 μg?L-1 . Compared with model control group, the survival rate of each group was remarkably increased, and the protective activities of PE and UA were more significant among them. Conclusion Different polar extracts of pyrola decorata and isolated ursolic acid have neuroprotective effects on Aβ25-35-induced cytotoxicity in PC12 cells in certain degrees.

Objective:To explore potential role and mechanism of N6-methyladenine(m6A)RNA methylation regulators in prognosis and tumor immune microenvironment of cervical cancer.Methods:Clinical and survival data as well as RNA sequencing data were acquired from TCGA and GEO database.Expressions and correlation among m6A RNA methylation regulators were analyzed by bioinformatics analysis and tissue validation experiments.LASSO Cox regression analysis was used to generate a prognostic risk sig-nature based on m6A regulators.Two m6A-modification patterns were identified based on m6A regulators and their abundance of im-mune cell inflitration were analyzed by ssGSEA.Results:Compared with normal tissues,RBM15,IGF2BP2,IGF2BP3,FMR1,YTHDF1,METTL3 and YTHDF2 expressions were significantly up-regulated in cervical cancer tissues,while ZC3H13,METTL4,YTHDC1,FTO and ALKBH3 expressions were significantly down-regulated.Five m6A regulators HNRNPC,LRPPRC,METTL3,ELAVL1 and FMR1 were selected to establish prognostic risk signature,whose expressions in cervical cancer were verified by HPA database and qRT-PCR with good predictive value,and could be used as independent poor prognostic factor(AUC=0.734).Based on expressions of 25 m6A regulators,two m6A modification patterns m6Acluster A and m6Acluster B were determined.There were differ-ences between two groups in biological functions,signal pathways and immune cells infiltration levels in tumor microenvironment.Conclusion:m6A RNA methylation regulators are closely related to prognosis and immune infiltration of cervical cancer,which provides guidance for immunotherapy strategy.

Objective:To evaluate and compare the early and long-term outcomes of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement, and analyze the difference of early mortality and long-term survival rate between mild pulmonary artery systolic pressure (PASP) and moderate to severe PASP patients.Methods:From January 2009 to December 2018, 79 cases of patients were reviewed and summarized. The mean age before operation was (45.7±7.8) years old. These patients were divided into mild PASP group(<50 mmHg, 38 cases) (1 mmHg=0.133 kPa) and moderate-severe PASP group (>50 mmHg, 41 cases) . Kaplan- Meier method was used to estimate the overall long-term survival rate and the incidence of complications, and to compare the long-term survival rate of patients with mild and moderate -severe PASP elevation. Results:The mortality rate of early postoperative patients was 8.9% (7/79). The causes of death included: low cardiac output syndrome in 3 cases, multiple organ failure caused by pulmonary infection in 2 cases, acute renal insufficiency in 1 case, sudden cardiac arrest in 1 case. Although the mortality rate of early moderate-severe PASP group (12.2% vs. 5.3%) was higher than that of mild PASP group, there was no significant difference ( P>0.05). The mean follow-up time was (51.8±31.7) months (3-115 months). Kaplan- Meier method was used to estimate the 10-year survival rate, the rate of avoiding thrombosis, the rate of avoiding serious bleeding event and the rate of avoiding reoperation, which were (67.2±10.6)%, (85.7±6.2)%, (83.4± 6.9)% and (93.7 ± 3.7)%, respectively. Although the long-term survival rate of mild PASP (78.0±10.6) % was higher than that of moderate-severe PASP (62.8 ± 13.4) %, there was no significant difference ( P>0.05). Conclusion:The early mortality rate of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement is still relatively high. The recurrent heart failure is the major causes of long-term death.