Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Thrombotic Microangiopathies ; etiology

Anemia, Aplastic ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Transplantation, Homologous

ObjectiveTo investigate the efficacy of low-molecular-weight heparin (LMWH)combined with warfarin in advanced lung cancer patients with acute non-massive pulmonary embolism (PE) and the effect on dyspnea symptom.MethodsFifteen (stage Ⅲ B-Ⅳ ) lung cancer patients with PE from July 2008 to June 2010 were enrolled.All the patients were diagnosed as acute non-massive PE according to spiral computed tomography pulmonary angiography (SCTPA).Enoxaparin (1 mg/kg) was injected with subcutaneous injection twice a day for 7-14 days.Oral warfarin was added once a day 48 h after enoxaparin injection and the dosage was adjusted according to international normalized ratio (INR) level(maintain 2.0-3.0).The medical research council (MRC) grade,results of arterial blood gas analysis and adverse reactions were observed.ResultsSix patients were accompanied with deep venous thrombosis (DVT)according to vascular Doppler ultrasound,2 patients were died at the 6th day and 11th day due to multiple organ dysfunction syndrome.Six patients were cured.5 patients were good,2 patients were improved.The median survial time was 9.2 months.Thirteen patients' MRC grade was decreased trom (3.1 ± 0.5 ) grades to ( 1.9 ± 0.8 ),( 1.5 ± 0.5 ),(0.6 ± 0.6) grades,arterial oxygen pressure (PaO2) was raised from (60.5 ± 7.2)mm Hg (1 mm Hg=0.133 kPa) to (76.1 ±9.7),(81.6±9.2),(86.2±7.5) mm Hg,plasma D-dimer was decreased from (9.44 ± 5.29 ) mg/L to (4.33 ± 3.34 ),(0.88 ± 0.32 ),( 0.41 ± 0.1 7 ) mg/L and alveolar-arterial oxygen tension gradient [ P( A-a)O2 ] was increased from ( 38.5 ± 6.7 )mm Hg to ( 35.5 ± 5.1 ),(29.3 ± 3.2),(24.1 ± 4.1 ) mm Hg after 4,7,14 days of the treatment.There were significant differences in PaO2,MRC grade,plasma D-dimer before and after 4,7,14 days of the treatment(P ＜ 0.05),there was significant difference in P ( A-a)O2 before and after 7,14 days of the treatment (P＜ 0.05).There was no patient with big hemorrhage and thromboembolism during anticoagulant therapy.ConclusionsFor advanced lung cancer patients,the combination therapy with LMWH and warfarin for acute non-massive PE appears to be safe and effective on improving dyspnea symptom and hypoxemia.Adverse reaction is seldom.

Objective To evaluate the effects of proportional assist ventilation (PAV) and pressure support ventilation (PSV) on ventilate parameters of patients with chronic obstructive pulmonary disease (COPD) combined with respiratory failure.Methods Fifteen intubated stable patients recovering from acute exacerbation of COPD combined with respiratory failure were randomized to receive PAV or PSV support 60 min and then crossed over to alternative mode.Respiratory mechanics including respiratory systemelastic resistance and airway resistance were monitored by least square fitting (LSF) methed.During PAV support.the ratio of volume assist (VA) and flow assist (FA) level wag 80%.The ventilate parameters and arterialblood gas at different ventilate condition was observed.Results Compared with low level PSV (PS 10 cm H2O,1 cm H2O=0.098 kPa,PS10),tidal volume in high level PSV (PS 15 cm H2O,PS15) and PAV was significantly increased [(443±12)ml vs(532±34)ml,(464±23)ml,P<0.05].There was no difference in respiratory rate and peak inspiratory pressure between PAV and PS10.Airway occlusion pressure and time product of triggering was d()reased from (5.70±0.25)cm H2O to (4.53±0.25)cm H2O and (0.42±0.04) cm H2O to (0.32±0.03)cm H2O(P<0.05),PaO2/FiO2 ratio and PaCO2 was also significantly improved after PAV supported compared with PS10,and similar with PS15.The rapid shallow breath index at PAV was similar with PS10.Condusion As a positive feedback system,PAV seems more efficacious than low level of PSV in decreasing the work of breathing during the inspiratory phase,resulting in fewer patient-ventilator asynchronism,and it may be beneficial for weaning.

Objective To investigate the severity of airflow obstruction in stable COPD patients and to assess the effects of salbutamol by analysis of tidal breathing flow-volume curves(TBFV).Methods 61 moderate-to-severve COPD patients and 68 normal controls were performed pulmonary function test and TBFV loops in seated position.Measurements of TBFV loops and spirometry were performed at rest after salbutamol 400 ?g inhalation in 26 COPD patients.Results COPD patients exhibited a significant decrease in FEV_1%、FEV_1/FVC、FEF50% and FEF75%.The fraction of exhaled volume to achieve PTEF to V_(TE)(V_(PTEF)/V_(TE))and the fraction of exhaled time to achieve PTEF to T_(E)(T_(PTEF)/T_(E))were lower than 18%[(12.8?2.7)% and(11.6?2.4)%],and much lower than normals(25.0?3.1)% and(29.5?3.7)%.But peak tidal expiratory flow(PTEF)and peak tidal inspiratory flow(PTIF)were decreased slightly.After salbutamol administration,26 COPD patients exhibited a significant increase in TEF50%(21.5?6.8)% versus(15.6?4.2)%,P

Humans ; Sialorrhea ; etiology ; therapy

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) with multiple differentiation potential can be induced into osteogenic or adipogenic differentiation under certain conditions. OBJECTIVE: To review the related factors regulating the adipo-osteogenic differentiation of BMSCs. METHODS: A computer-based search of CNKI and PubMed databases was performed for literature concerning the related factors regulating the adipo-osteogenic differentiation of BMSCs published from January 2006 to August 2016. The search terms were bone marrow mesenchymal stem cells, osteogenic differentiation, adipocyte differentiation in Chinese and English, respectively. RESULTS AND CONCLUSION: Signaling pathways, transcription factors, and smal molecule compounds that are interacted are key factors in the regulation of BMSCs differentiation, so the techniques to intervene BMSCs differentiation based on these key molecules may correct bone or fat abnormality and can be applied to tissue engineering and regenerative medicine in the future. Additionally, the biological clock is also one of the most important factors for adipo-osteogenic differentiation of BMSCs by regulating signaling pathways or transcription factors.

Objective To survey the multi-drug resistance among the isolates of methicillinresistant Staphyloeocus from lower respiratory tract in post-cardiothoracic surgery patients and the risk factors contributing to infection aggravation.Methods The clinical data of lower respiratory tract infections were reviewed retrospectively from June 2011 to December 2012.The antimicrobial susceptibility testing was analyzed according to CLSI breakpoints 2010.Results A total of 323 clinical isolates was identified in 264 patients,including gram-positive coccus (126 strains) and gram-negative bacillus (197 strains).The prevalence of methiciIlin-resistant srtains was 88.5 ％ (54/61)in Staphylococus.Aureus (MRSA),and 77.3％ (17/22) in Staphylococcus epidermidis (MRSE).No VISA or VRSA strain was identified.One enterococcal strain was resistant to Vancomycin and teicoplanin.MRSA/MRSE were also isolated from hands and nasal vestibule of nurses,article surfae,pipeline/interface of breathing machine and ward atmosphere.Conclusions Patients after cardiothoracic operation are susceptible to lower respiratory tract infection with gram positive cocci,which should be paid more attention to airway management.Rational administration,sterile operation and antimicrobial therapy are effective ways for control of multi-durg resistance.

Objective To optimize the extracting process of alkaloid from Nelumbo nucifera leaves by multi-stage countercurrent extraction.Methods The spectrophotometry was used to determine the alkaloids.The extracting process of alkaloid was optimized by L16(44) to observe the effect of extraction time,extraction temperature,solid to liquid ratio,and ethanol concentration,respectively.Results The optimum extraction parameters were extraction time 25 min,extraction temperation 90 ℃,solid to liquid ratio 1∶50,and ethanol concentration 70%.Conclusion The multi-stage countercurrent extraction is used to the extracting process of alkaloid from N.nucifera leaves.