OBJECTIVETo study the effect of Shenmai Injection (SMI) on the clinical efficacy of noninvasive positive-pressure ventilation (NPPV) in treating patients with severe respiratory failure (RF) caused by chronic obstructive pulmonary disease (COPD).

METHODSPatients in the control group (n=23) were treated with conventional therapy plus NPPV, and those in the treatment group (n=25) received the same treatment but with intravenous infusion of SMI 30 ml once a day additionally. The treatment lasted for 10 days. Arterial oxygen saturation (SaO2) was continuously monitored in all patients, arterial blood gas values was determined before treatment and at the 6th hour, the 24th hour, the 3rd day and the 7th day after treatment, and consciousness, breath, heart rate and severity of dyspnea were observed during the treating period.

RESULTSAll patients in the treatment group were markedly improved and discharged from hospital, while in the control group 20 were improved and discharged from hospital, but the other 3 failed to be remitted and received the conventional invasive mechanical ventilation. The duration of hospitalization and ventilation were 11.3 +/- 2.5 d and 5.8 +/- 2.8 d in the treatment group, and 13.2 +/- 2.7 d and 7.5 +/- 3.0 d in the control group, showing significant difference in the two indexes between the two groups (P < 0.05). The dyspnea score and the arterial blood gas values determined on the 3rd and 7th day were significantly improved in the treatment group than those in the control group (P < 0.05 or P < 0.01). The incidence of endotracheal intubation caused adverse reaction, such as facial-skin crush wound, abdominal distention and contaminated infection in the treatment group was obviously lessened as compared with the control group.

CONCLUSIONSMI could shorten the duration of hospitalization and mechanical ventilation, reduce trachea cannulation, and decrease the incidence of complications and adverse reactions in the patients with severe RF due to COPD treated with NPPV.

Aged ; Aged, 80 and over ; Combined Modality Therapy ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Phytotherapy ; Positive-Pressure Respiration ; methods ; Pulmonary Disease, Chronic Obstructive ; complications ; Respiratory Insufficiency ; etiology ; therapy

The study was aimed to detect the expressions of costimulatory molecules on CD3(+)CD4(+) T cells so as to accumulate informations for investigation of mechanism of myelodysplastic syndrome. 11 healthy blood donors as control and 38 patients with MDS de novo were studied. 38 MDS patients were divided into RA/RARS group and RAEB/RAEB-t group according to FAB classification. The expressions of CD28, CD154, CTLA-4, PD-1, CD25 on CD3(+)CD4(+) T cells in peripheral blood were detected by FCM. The results indicated that as compared with normal controls, the expression of CD28 in MDS patients decreased, and CD154 increased. The percentages of CTLA-4, PD-1 and CD25 in MDS were obviously higher than that in normal controls; the differences of CTLA-4, PD-1 and the ratio of CTLA-4/CD28 between RAEB/RAEB-t and RA/RARS were more significant with progressing of MDS. In conclusion, the expressions of costimulatory molecule in MDS patients were abnormal, which may be involved in the pathogenesis of MDS.
Adult ; Antigens, CD ; metabolism ; Apoptosis Regulatory Proteins ; metabolism ; CD28 Antigens ; metabolism ; CD40 Ligand ; metabolism ; CTLA-4 Antigen ; Case-Control Studies ; Female ; Humans ; Interleukin-2 Receptor alpha Subunit ; metabolism ; Lymphocyte Count ; Male ; Middle Aged ; Myelodysplastic Syndromes ; immunology ; metabolism ; Programmed Cell Death 1 Receptor ; T-Lymphocytes ; immunology ; metabolism ; Young Adult

OBJECTIVETo compare the difference between digital subtraction angiography (DSA) and type B ultrasonography in the evaluation of vascular injury in patients inflicted with high voltage electrical injury.

METHODSNineteen patients with high voltage electrical injury of upper limbs were enrolled in the study as burn group, and another 12 healthy volunteers as controls. The endovascular membrane, vascular wall thickness, intra-vascular blood flow and endovascular thrombosis formation of ulnar and radial arteries at wound site and in regions 5, 10 and 15 cm proximal to the wounds were examined by DSA and type B ultrasonography and compared with imagings of healthy volunteers as control. The injury degree of the ulnar and radial arteries was examined during operation for evaluation to corroborate with DSA and ultrasonography findings. Necrotic and/or thrombotic vessels were excised and sent for pathomorphological examination.

RESULTSBy DSA images abnormal signs as thrombosis, vascular lumen stenosis and blood flow deceleration were found in 14 ulnar and 11 radial arteries, and the signs were more pronounced in ulnar arteries. By type B ultrasonography, abnormal signs as roughing of tunica intima, swelling or exfoliation, thickening of vascular wall, lumen stenosis, decreased blood flow, even necrosis of vascular wall and thrombosis were identified in 19 ulnar and 16 radial arteries in burn group (P < 0.05 approximately 0.01). The blood flow in ulnar artery 5 cm to the approximal part of the wound edge was obvious lower than that of the control (31.60 +/- 13.90 ml/min vs 47.70 +/- 9.60 ml/min, P < 0.05).

CONCLUSIONType B ultrasonography and DSA could be helpful in the evaluation of vascular injury in patients inflicted with high voltage electrical injury.

Adult ; Angiography, Digital Subtraction ; methods ; Burns, Electric ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Radial Artery ; diagnostic imaging ; injuries ; Ulnar Artery ; diagnostic imaging ; injuries ; Ultrasonography, Doppler, Color ; methods

[Objective]To investigate the characteristics of immunophenotypes in hepatocellular carcinoma(HCC) before liver transplantation.[Methods]The immunophenotypes of T-,B- cells,monocytes,dendritic cells(DC)and NK-cells in peripheral blood from 6 HCC patient who were ready to have liver transplantation and 6 healthy volunteers were analyzed by multicolor flow cytometry.[Results]In the patients,the proportions of CD4+PD-1+T cells,Treg cell (CD4+CD25+CD39+T cells),CD19+B cells,Plasmablasts(CD27highCD38highIgD-IgM-),classical monocytes(CD14high CD16-)and mature NK-cells(CD3-CD56high)were all higher than those in the healthy controls(all P<0.05).However, marginal zone B cell(CD27+IgD+),Non-switched B cells(CD27+CD38dimIgM+),intermediate monocytes(CD14high CD16+)and immature NK-cells(CD3-CD56+)were lower than those in the healthy controls(all P<0.05). And there wasn't any obvious difference in quantity being observed among other cell types.[Conclusion]There was difference in the immunophenotypes of immune cells in peripheral blood between HCC patients before liver transplantation and healthy people.And this finding exerts important effects on monitoring the immune status of the patients after liver transplantation and guiding the administrations of immunosuppressors.