Objective To study the relation between kidney function impairment and respiratory tract infections(RTI) in the elderly.Methods Two hundred and twenty-four patients above 65 years old were divided into five groups according to stages of chronic renal disease and estimated glomerular filtration rate (e GFR):(A group,n =65):≥90 ml/(min · 1.73 m2),(B group,n =55):60-89 ml/(min · 1.73 m2),(C group,n =27):30-59 ml/(min · 1.73 m2),(D group,n =28):15-29 ml/(min · 1.73 m2) and(E group,n =49):＜ 15 ml/(min · 1.73 m2).Taking A group as the control baseline.Logistic regression was employed to analyze the relationship between kidney function and RTL Results Compare with A group(10.8％,7/65),the incidences of RTI in three groups(C group,D group and E group were 63.0％ (17/27),85.7％ (24/28) and 100％ (49/49) respectively.The incidence in these groups was higher than that in A group(x2 =26.95,49.46 and 89.00 respectively,P ＜ 0.05).We identified the risk factors with RTI were smoking (Waldx2 =17.66,P ＜ 0.01),respiratory underlying diseases(Waldx2 =14.38,P ＜0.01),invasive operation history(Waldx2 =4.50,P ＜ 0.05),diabetes (Waldx2 =3.86,P ＜ 0.05),stay in hospital for above 2 weeks (Waldx2 =18.18,P ＜ 0.01),Gender(Waldx2 =4.12,P ＜ 0.05),eGFR (Waldx2 =13.57,P ＜ 0.01).After adjusting for other risk factors of RTI,Logistic regression analysis showed that the risk of RTI still increased with the decrease of eGFR (eGFR≥90 ml/(min · 1.73 m2):(Waldx2 =0.053,P ＞0.05);60-89 ml/(min · 1.73 m2):(Waldx2 =0.046,P＞0.05) ;30-59 ml/(minl · 1.73 m2):(Waldx2 =7.61,P＜0.05),15-29 ml/(min · 1.73 m2):(Waldx2 =4.38,P＜0.05); ＜15 ml/(min · 1.73 m2):(Waldx2 =13.57,P＜0.01)).Conclusion Kidney function impairment in patients above 65 years old is an independent risk factor for RTI.

0.05). Conclusion: DUP related to short-term prognosis of first-episode schizophrenia patients, the DUP is shorter, the prognosis is better, DUP was related factor of relapse.

Objective To investigate the association of serum adiponectin and tumor necrosis factor alpha (TNF-α) with endothelial damages in metabolic syndrome (MS) patients. Methods One-hundred and five patients diagnosed as MS were recruited as cases and 37 subjects without characteristics of MS were recruited as controls. The cases were divided into two groups according to the level of serum von Willebrand factor (vWF) :normal endo-thelial functional MS group (57 patients) and abnormal endothelial functional MS group (48 patients). Serum adi-ponectin concentration was measured by enzyme-linked immanosorbont assay (ELISA). Serum TNF-α concentration was measured by radioimmunoassay (RIA). Results The concentration of serum adiponectin in normal subjects (10.5 mg/L [SD:3.2]) was significantly higher than both that of normal endothelial functional MS group (7.9 mg/L [SD :2.2]) and abnormal endothelial functional MS group (6.5 μg/L [SD :2.5]) (P < 0.05). The concen-tration of serum TNF-α in normal subjects(0.17 μg/L [SD :0.04]) were significantly lower than that of normal en-dothelial functional MS group (0.19 μg/L [SD:0.05]) and abnormal endothelial functional MS group (0.23 ng/mi [SD: 0.06]) (P< 0.05). The level of serum adiponectin were negatively correlated with TNF-α(r=- 0.555, P < 0.01). Logistic regression analysis results showed that high level of TNF-α was a risk factor of endo-thelial damages (OR = 20.649, P = 0.035), whereas high level of serum adiponectin protected against endothelial damages (OR = 0.340,P=0.006). Conclusions Low level of serum adiponectin and high level of serum TNF-α may correlate with endothelial damages in MS patients.

Objective To study the effect of local mild hypothermia on serum brain natriuretic peptide (BNP) in patients with acute intracerebral hemorrhage.Methods Sixty patients with acute intracerebral hemorrhage were divided into local mild hypothermia group (30 cases) and routine therapy group (30 cases) by random digits table method.Routine therapy group was given conventional therapy,and local mild hypothermia group was given local mild hypothermia treatment besides conventional therapy.The neurologic impairment was evaluated according to American National Institute of Health Stroke Scale (NIHSS) scores on admission,and on the 3rd,7th and 14th day after treatment.Serum BNP levels in patients were determined dynamically on admission,and on the 3rd and 14th day after treatment.The effect was evaluated on the 14th day after treatment.Results There was no significant difference in serum BNP on admission between two groups (P ＞ 0.05).Serum BNP on the 3rd,14th day after treatment in local mild hypothermia group was lower than that in routine therapy group[(153.47 ± 32.01) ng/L vs.(187.45 ± 40.21)ng/L and (111.02 ± 38.27) ng/L vs.(139.71 ± 29.53) ng/L],and there was significant difference(P ＜ 0.01 or ＜ 0.05).There was no significant difference in NIHSS scores on admission and on the 3rd day after treatment between two groups (P ＞0.05).NIHSS scores on the 7th and 14th day after treatment in local mild hypothermia group was lower than that in routine therapy group [(13.84 ± 6.00) scores vs.(16.59 ± 4.62)scores and (9.23 ± 4.48) scores vs.(13.02 ± 6.76) scores],and there was significant difference (P ＜ 0.01).The total effective power in local mild hypothermia group was higher than that in routine therapy group[90.0％(27/30) vs.66.7％ (20/30)],and there was significant difference (P ＜ 0.05).Conclusions The local mild hypothermia therapy can not only significantly improve the defect of nerve function in patients with acute intracerebral hemorrhage but also reduce the serum BNP.It can improve the curative effect in patients with acute intracerebral hemorrhage.

Objective To study the IgG antibodies on red cell surface in ABO and Rh-incompatible infants and to evaluate its predictive value for hemolysis. Methods From Nov. 2001 to Jul. 2002,50 full term newborn babies with ABO and Rh incompatibility hemolysis were admitted .They were divided into two groups according to the direct Coombs test(DCT): 38 cases with positive result and 12 cases were negative. Another 30 normal newborns were chosen as control group. Erythrocyte associated IgG,A and M were measured by a flow cytometry (FCM). Results the mean level of concentration of IgG antibodies in positive DCT group was (12.64?16.83)%,while (4.54?2.54)% in negative DCT group ( P 427.5 ?mol/L,IgG was elevated with the increased TSB level. There was a close relationship between the concentration of TSB and IgG ( r =0.678). Conclusion Measurement of erythrocyte surface antigen IgG assists the diagnosis of maternal-fetal incompatible hemolysis,especially when with a positive direct Coombs test result.

Before and after treatment as well as before metastasis,the combined detection of progastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE) was performed in 150 patients with small cell lung cancer.The follow-up period was 1 year.Enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay were conducted.The result showed a negative correlation between the serum levels of ProGRP and NSE the curative effect.And a positive correlation existed between the serum levels of ProGRP and NSE and disease development.The difference had statistical significance (P ＜ 0.05).The levels of ProGRP and NSE may be used to indicate the disease development and evaluate the curative effect.

10.3969/j.issn.1000-8179.2013.12.004

Objective To compare the noxious stimulations induced by insertion of Proseai laryngeal mask airway(PLMA)and classic laryngeal mask airway(CLMA)in children.Methods Forty-seven ASA Ⅰ or Ⅱ children,aged 3-12 yr and undergoing surgery under general anesthesia,were randomly divided into 2 groups:PLMA group(group P,n =23)and CLMA group(group C,n =24).General anesthesia was induced with target-controlled infusion(TCI)of propofol.When the effect-site concentration of propofol was equal to the plasma concentration predetermined.PLMA or CLMA insertion was attempted.The target plasma concentration of propofol was predetermined according to Dixon's up-down method,with 0.2 μg/ml as a step size.The initial target plasma concentration of propofol was 6 μg/ml and 4.4 μg/ml for groups P and C,respectively.The preedetermined target plasma concentration of propofol and the satisfaction of insertion conditions for each child were recorded.Results The 50％ effective concentration(EC50)of propofol to achieve satisfied condition of PLMA and CLMA insertion were 5.87(95％ CI,5.62-6.11)and 4.53(95％ C1,4.38-4.69)μg/nl,respectively,and the difference was significant(P ＜ 0.01).Conclusion The noxious stimulation induced by insertion of PLMA in children aged 3-12 years is stronger than that of CLMA.

Objective Though measuring the expression levels of blood aryl hydrocarbon receptor (AhR) and cytochrome P-450 1A1 (CYP1A1),to explore the relationship between the expression levels and chronic arsenic poisoning induced skin changes.Methods Totally 233 residents were selected in Hanggin Rear Banner arsenic exposure area of Bayannur City,according to water arsenic concentrations,these people were divided into control (＜ 10 μg/L,55 people),low (10-＜ 100 μg/L,47),medium (100-＜ 200 μg/L,45) and high (≥200 pg/L,86) arsenic exposure groups.Real-time PCR was used to detect the expression levels of blood AhR and CYP1A1 mRNA,which were presented in median and quartile [M (Q1-Q3)],and the relationships between their expression levels and keratosis,depigmentation of skin were analyzed.Results The relative expression levels of AhR and CYP1A1 mRNA in high-dose groups were 3.18 × 10-3 (2.42 × 10-3-4.45 × 10-3) and 1.58 × 10-3 (0.80 ×10-3-2.73 × 10-3),which were higher than those in control groups [2.30 × 10-3 (1.53 × 10-3-3.20 × 10-3) and 1.00 × 10-3 (0.59 × 10-3-2.09 × 10-3)],and the difference were statistically significant (all P ＜ 0.05).Compared with control group,the detectable rates of arsenic poisoning,keratosis and depigmentation of skin were higher,and the differences were statistically significant (x2 =20.187,15.848,21.595,all P ＜ 0.05).The detectable rates of arsenic poisoning,keratosis and depigmentation of skin were increased with increase of water arsenic concentrations (x2 =19.012,15.269,16.868,all P ＜ 0.05).Compared with normal [2.54 × 10-3 (1.79 × 10-3-3.43 × 10-3),2.57 × 10-3 (1.78 × 10-3-3.52 × 10-3)],AhR mRNA relative expression levels [4.45 × 10-3 (3.47 × 10-3-8.04 × 10-3),4.45 × 10-3 (4.02 × 10-3-6.25 × 10-3)] of degree Ⅲ keratosis and depigmentation of skin were increased,and the differences were statistically significant (all P ＜ 0.05).Conclusions Chronic arsenic exposure affects the expression level of AhR and CYP1A1 mRNA.Blood AhR mRNA expression may have relationship with endemic arsenic poisoning induced skin change,but blood CYP1A1 mRNA expression may have nothing to do with endemic arsenic poisoning induced skin change.

ObjectiveTo investigate the treatment effects of comprehensive nursing intervention on patients with chronic obstructive pulmonary disease(COPD) treated by non-invasive mechanical ventilation with BiPAP mode.Methods96 patients with diagnosed COPD and using non-invasive mechanical ven- tilation with BiPAP mode were randomly divided into the control group(46 cases) which was treated with routine measures and the comprehensive nursing intervention group (50 cases) which adopted comprehen- sive nursing intervention according to experimental design. The frightening degree, incidence rate of com- plications and clinical treatment effect by ventilator were compared between the two groups.ResultsPa- tients compliance with treatment and clinical treatment effect by ventilator in the comprehensive nursing in- tervention group was better than that of the control group. The frightening degree and incidence rate ofcomplications were lower than those of the control group (P < 0.01 ).ConclusionsComprehensive nurs-ing intervention with non-invasive mechanical ventilation with BiPAP mode can improve the treatmentcompliance of COPD patients,reduce complications followed by non-invasive mechanical ventilation andreach the prospective treatment effect.