Objective To evaluate the clinical value bronchofiberscope and perfusion in the treatment of multi- drug resistant pulmonary tuberculosis (MDR-TB).Methods Forty-two cases were treated by injecting amikacin (0.4 g), ofloxacin (0.4 g), after cleaning up exudation through bronchofiberscope and catheter intervention combined with chemotherapy therapy, while 37 controls were treated by chemotherapy only.Results By the end of 9 months, the sputum tubercle bacillus conversion rate, radiographical improvement rate were 92.9% and 90.5% respectively in the treated groups,while all these indications were higher than those of control group 62.2% and 59.5% (P

To explore the clinical efficacies of hyperbaric oxygen therapy on the recovery of cognitive function in stroke patients on hemodialysis.Forty stroke patients on hemodialysis were assigned randomly into hyperbaric oxygen therapy (HBO) (n =20 ) and routine therapy groups (n =20).Patients of HBO group received both hyperbaric oxygen therapy and routine therapy.Nerves functions and cognitive function were observed before and after therapy to compare the clinical outcomes.Neuropsychological tests,minimental status examination (MMSE) and activities of daily living (ADL) were used for assessing cognitive function.Then the outcomes were compared with those of the control group.Nerves function and cognitive dysfunction of the treatment group had significant improvement (P ＜ 0.01).Hyperbaric oxygen can significantly improve cognitive dysfunction in stroke patients on hemodialysis.

Objective To study the right ventricular function of patients with pulmonary thromboembolism by using color Doppler ultrasound.Methods 31 patients with acute pulmonary thromboembolism,compared with 31 vohnteers,were enrolled in this study.The right ventricular anterior wall movement,right ventricular end diastolic volume,right ventricular ejection fraction,and myocardial performance index were observed by echocardiography.Resuits The right atrium diameter,right ventricles diameter,right ventrieular end diastolic volume and pulmonary artery inner diameter in study group were much larger than that in control group (P<0.01),and the right ventricular anterior wall movement and right ventrieular ejection fraction decreased in study group (P<0.01).Tricuspidal annular E peak velocity tended to be decreased,isovolumie relaxation time and isovolumic contraction time were prolonged and myocardial performance index was increased (P<0.01).Right ventricular myocardial performance index showed significant correlation with right ventrieular ejection fraction (r=0.78,P<0.01),isovolumic relaxation time and isovolumic contraction time(rl=0.88,r2=0.57,P<0.01).Conclusion The right ventricular function in patients with pulmonary thromboembelism is decreased and myocardial performance index is a sensitive index which can be used to reflect right ventricular function in pulmonary thromboembolism.

OBJECTIVE To strengthen management of nosocomial infections in comprehensive intensive care unit so as to enhance medical treatment quality.METHODS Nosocomial infection administration department constituted the management institutions and standards of nosocomial infections with supervising,implementing targets monitoring.Comprehensive intensive care unit instituted several groups of nosocomial infection management and fulfiled the precautions and control measures.RESULTS By means of interventions and prophylaxes,the occurrence of nosocomial infection in comprehensive intensive care unit decreased.CONCLUSIONS It ensures for medical treatment quality and safe by strengthening the management of nosocomial infections.

Objective: To establish a method for the determination of cinnamic acid in Lingguizhugan Decoction (Poria, Ramuls Cinnamomi, Rhizoma Atractylodis macrocephalae, Radix Glycrrhizae, etc.). Methods: Using RP HPLC with Hypersil C 18 column, methanol acetonitrile water acetic acid (10∶22∶70∶1.4,v/v) as mobile phase, detection wavelength at 254nm and p dimethylaminobenzaldehyde as the internal standard.Results: The mean recovery and RSD were 98.2% and 1.9% ( n =6), respectively, the linear range of cinnamic acid was 8.4～168?g?mL -1 ( r =0.9999). Conclusion: The method is simple, rapid, accurate and reproducible, and may be used for the determination of cinnamic acid in Lingguizhugan Decoction.

Objective To explore and compare the mechanism of high-fructose and high-fat diet induced triglyceride excessive accumulation in mice liver and its relationship with endoplasmic reticulum (ER) stress.Methods 45 Adult male C57BL/J6 mice,weight arranged from 25 gram to 30 gram were randomly divided into control group,high-fructose group and high-fat group,15 mice in each group.Common food was fed in control group,high-fructose food was fed in high-fructose group,high-fat food was fed in high-fat group,and the everyday calories consumption in 3 groups was almost equal.Intraperitoneal glucose tolerance test (ipGTT) was performed after feeding for 8 weeks.After mice were sacrificed,triglyceride content,lipogenic enzymes and ER stress markers expression in liver tissues of each group were measured.Results After feeding with different food for 8 weeks,the fat content of epididymis in high-fructose group and high-fat group both was (2.0±0.1) g/100 g (body weight),which was significantly higher than that of control group (1.2 ± 0.1) g/100 g (body weight),P＜0.01).After ipGTT test,the area under curve of blood glucose in high-fructose group and high-fat group was significantly higher than that in control group (P＜0.01).Compared with control group,triglyceride contents of liver tissues in high-fructose group and high-fat group were significantly increased,of those triglyceride contents in high-fructose group increased more obviously,and triglyceride contents in high-fructose group was significantly higher than that of high-fat group (P＜0.01).Compared with control group,the expression of acylCoA carboxylase (ACC),fatty acid synthase (FAS) and stearoyl-CoA desaturase 1 (SCD-1) increased in high-fructose group (P＜0.01),while decreased in high-fat group (P＜0.05) ; meanwhile,the expression of phosphorylated pancreatic ER kinase (p-PERK),inositol requiring enzyme 1 (p-IRE-1/t-IRE-1)and glucose-regulated protein 78 (GRP78) was up-regulated in both high-fructose group and high-fat group (all P＜0.01).Conclusion Both high-fructose diet and high-fat diet can induce fatty liver through different mechanisms.High-frucose diet promotes endogenous lipogenesis while high-fat diet inhibits endogenous lipogenesis.Both dietary factors can induce ER stress,which indicate that ER stress is associated with pathogenesis and development of food factors induced fatty liver.

Objective To investigate the braking time in diagnosis of lipohemarthrosis by ultrasound. Methods Experiment group:After 20 tubes containing fresh blood and pig marrow were uniformly mixed, they were instantly continuously detected by high-frequency linear array transducer in fixed-area at short-interval.Clinical group: Ten walking patients with lipohemarthrosis were examined with continuous detection by ultrasound,CT and MR before operation.Results Experiment group: Cloudy echo and slowly floating up of lipoids were detected at the beginning.After 2.7 to 3.7 minutes (average 3.17 minutes), the liquid was divided into two layers with vague boundary.After 5.3 to 8.0 minutes (average 6.75 minutes) ,the liquid was divided into 3 layers with thickening serum laye.Clinical group: Ultrasound findings: Cloudy medium echo was detected at first.After 2.0 to 4.0 minutes (average 3.08 minutes),the liquid was divided into two layers.After 4.4 to 10.0 minutes (average 6.92 minutes) , the liquid was divided into 3 layers with thickening serum layers.Three knees showed fracture line and 2 knees with occult fracture were diagnosed as lipohemarthrosis.CT and MR findings: Ten knees showed fracture line in CT examination,of which 7 knees showed double liquid-liquid layer and 3 knees showed single liquid-liquid layer in the suprapatellar bursa.Ten knees showed fracture line in MR examination,6 knees showed double liquid-liquid layer and 4 knees showed single liquid-liquid layer in the suprapatellar bursa. Conclusions The best braking time in diagnosing lipohemarthrosis by ultrasound can be shorten to 10 minutes and the necessary braking time is 2 to 4 minutes.

Objective To compare the effects of pulse high-volume hemofiltration (PHVHF) and continuous veno-venous hemofiltration (CVVH) on severe acute panceatitis (SAP). Method From January 2005 to December 2009, a total of 38 patients with SAP were randomly(random number) divided into PHVHF group ( n = 18)and CVVH group ( n = 20). After hemofiltration for 72 hours, clinical symptoms, APACHE Ⅱ score, biochemical changes and mortality were observed. The levels of TNF-α, IL-6, and IL-10 in plasma were assayed by using ELISA before and after treatment. The doses of dopamine used in shock patients were also observed. Measurement data were expressed in(-x) ± s, and t-test was used for comparison between two groups. Results In both groups ,symptoms were markedly improved after treatment. The APACHE Ⅱ score, serum amylase, creatinine, and white blood cell count were decreased ( P ＜ 0.05). Besides, hypoxemia and acidosis were corrected, and the PHVHF group was superior to the CVVH group especially in heart rate, breathing and APACHE Ⅱ score ( P ＜ 0. 05).The levels of TNF-α, IL-6 and IL-10 decreased in both groups ( P ＜ 0.05), and the PHVHF group was superior to the CVVH group ( P ＜ 0. 01 ). The doses of dopamine used in shock patients also decreased in both groups ( P ＜0. 01 ), and they decreased more in PHVHF group than in CVVH group ( P ＜ 0.05). The mortality was 11.1%in PHVHF group and 25 % in CVVH group. Conclusions PHVHF is obviously superior to CVVH in the treatment of SAP, and can serve as an important adjuvant therapy for SAP, stabilizing the hemodynamics and reducing the levels of pro-inflammatory factors and mortality.

Objective To investigate the relationship between oxidative stress and lipid metabolism characteristics in elderly patients under different status of thyroid function. Methods Eighty-six newly-diagnosed elderly patients with thyroid diseases,83 non-elderly patients with thyroid diseases and 20 normal subjects as control were selected.and 47 hyperthyroidism and 39hypothyroidism in elderly,43 hyperthyroidism and 40 hypothyroidism in non-elderly were diagnosed according to diagnostic criteria of the thyroid disease.The levels of fasting plasma malondialdehyde(MDA),superoxide(SOD)and oxidized low density lipoprotein(OX-LDL)were measured by thiobarhiturates,colorimetric method and enzyme linked immunosorbent assay(ELISA).Meanwhile,lipid profile and thyroid function were also measured,SOD/MDA ratio was calculated. Results Lipid profiles in the elderly hyperthyroidism group were significantly higher than those in the non-elderly group(P＜O.05 or P＜0.01)but were significantly lower than those of normal control group(P＜0.05 or P＜0.01).The plasma MDA[(10.23±6.29)μmol/L vs.(3.66±2.53)μmol/L vs.(7.37±4.58)μmol/L],free fatty acids(FFA)[(0.86±0.58)mmol/L us.(0.45±0.12)mmol/L vs.(0.61±O.46)mmol/L]and SOD levels were significantly higher in elderly patients with hyperthyroidism than in normal control and non-elderly hyperthyroidism groups(P＜0.05 or P＜O.01).In the patients with hypothyroidism,the plasma MDA[(9.03±5.98)μmol/L vs.(6.59±3.18)μmol/L vs.(3.66±2.53)μmol/L],OX-LDL[(387.36±71.04)μg/L vs.(355.22±45.01)μg/L vs.(324.53±56.19)μg/L],TC,LDL-C,non-HDL-C,LP(a) and Apo-B100 levels were significantly higher in the elderly group than in the non-elderly and normal control groups(P＜0.05 orP＜0.01).The SOD/MDA ratio was significantly lower in the elderly patient groups with hyperthyroidism or hypothyroidism than in normal control and non-elderly groups(all P＜0.01).In a multiple step-wise regression analysis.FT4 and FFA were independent factors related tO MDA in hyperthyroidism group,and non-HDL-C and LDL-C were independent factors related to MDA inhypothyroidism group. Conclusions Serious lipid metabolic disorder exists in newly-diagnosed and untreated elderly patients with hyperthyroidism and hypothyroidism.It is suggested that oxidative stress is obviously strengthened in elderly patients with thyroid function disorder and that the degree of oxidative stress is correlated with lipid metabolic disorder.