Objective NAC therapy was used to observe the effect of TNF-?,hs-CRP,PaO2,PaCO2and lung function in patients with COPD,so as to evaluate the therapeutic effect. Methods 65 patients with COPD were recruited and the patients were randomly divided into 2 treatment groups:control group (n=31) and experimental group (n=34). Patients in the two groups received the conventional treatment of COPD in unchanged dosage for the duration of the study except stopping using antibotic drug after infection was resolved. NAC tablets were taken orally at a dose of 600mg once a day in experimental group. After 8 weeks treatment,we appraised lung function and the plasma level of TNF-?,hs-CRP,PaO2 and PaCO2. Results Compared with normal controls,the plasma levels of TNF-? and hs-CRP increased significantly. The higher level of those ,the higher lung function class was in 65 COPD patients,and there was significant effect(P

Objective To design and develop an air purification system for intensive care ambulances,which can effectively purify the air in the compartment and sterilize the microbes in the air.Methods By integrating titanium dioxide photocatalysts with air filtration materials,an air purification system was designed that was capable of effective sterilization of microbes in the air via photocatalytic oxidation and decomposition,and of effective filtration of particles in the air through HEPA filters.The protection effect was evaluated by air filtration and sterilization tests in accordance with the related national standards.Results The air cleanliness could reach the 100 000 level with bacteria counts no more than 1 CFU per pan for 15 minutes in the ambulance compartment when the air purification system worked normally,which could meet the demands of environmental hygienic standards for intensive care units.Conclusion The air purification system can effectively purify and sterilize the air in the compartment of an intensive care ambulance.The effects of air purification meet the requirements of related hygienic standards,which can satisfy the demands of treatment and intensive care for the victims in the ambulance.

Objective To observe therapeutic effects of HuGanJieXian decoction on rats hepatic fibrosis induced by tetrachloride. Methods Rat models of hepatic fibrosis were constructed by intraperitoneal injection of tetrachloride.HuGanJieXian decoction composed of low, middle, and high dose curcumin were given to these rats respectively at the same time. Sho-saiko-to compound treatment group and Fufangbiejiarangan Tablets treatment group were made as positive control groups. After twelve weeks, all rats were executed. Serum samples were kept for measuring serum levels of PC-Ⅲ, LN, and HA. Left livers were extirpated for pathologic examination including H.E and Masson stainings. Grade of hepatic fibrosis were evaluated according to SSS system. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) of supematant centrifugated from hepatic tissue homogenate were detected. Results Serum levels of PC-Ⅲ, LN, and HA were depressed obviously in decoction groups compared with those of fibrotic group (P<0.05) , especially in the low-dose curcumin group.HuGanJieXian Decoction could increase the level of SOD and decrease the level of MDA (P<0.05) , especially in the low-dose curcumin group. Staining of H. E and Masson showed that degrees of hepatic fibrosis in decoction groups were improved obviously compared with that of the fibrotic group. Conclusion HuGanJieXian Decoction can improve rat hepatic fibrosis, the mechanism of this effect may be associated with protecting hepatic cell membrane and anti- peroxidative damage.

OBJECTIVETo investigate the influence of different pressures of CO2 pneumoperitioneum on pathomorphism and function of intestines following laparoscopic gastrectomy (LG).

METHODSForty-eight gastric cancer patients were prospectively enrolled in the study. Among them, 36 patients scheduled for elective LG were randomly assigned to low pressure group (LP), middle pressure (MP), and high pressure group (HP) with 12 cases in each group. The CO2 pneumoperitoneum pressure was maintained at 8-10 mmhg in LP, 11-13 mmhg in MP, and 14-16 mmhg in HP. The control group was open gastrectomy group (OG) in 12 cases. The intestinal pathomorphism and level of plasma D-lactic acid before, during and after operation, and postoperative intestinal function of four groups were examined and compared.

RESULTSThere were no statistical differences in preoperative data among the four groups(all P>0.05). LG group was associated with a lower rate of surgical complications than OG (8.3% vs. 41.7%, P<0.05). No obvious damage of intestinal mucosa was found in OG group. Damage degree of intestinal mucosa after operation in LP, MP and HP groups was 0-1, 1-2, and 2-3 respectively. There was significant change in intestinal pathomorphism after operation in both HP and MP groups. The levels of D-lactic acid before operation were not significantly different among all the four groups, but increased significantly in each group after operation (all P<0.05). HP group had the highest level of plasma D-lactic acid and presented with delayed bowel sound return (4.5 d), time to first flatus (5.4 d), and intake (6.0 d) as compared to the other 3 groups (all P<0.05).

CONCLUSIONSLaparoscopic radical gastrectomy is safe and minimally invasive. Higher pneumoperitoneal pressure is harmful to the recovery of intestinal mucosa and function. Therefore the pneumoperitioneum pressure should be maintained as low as possible under clear visualization during operation.

Gastrectomy ; Humans ; Intestines ; physiology ; Laparoscopy ; Pressure ; Stomach Neoplasms ; surgery

To explore the diagnostic value of 75 commonly used clinical laboratory markers for differentiation of traditional Chinese medicine syndromes such as liver and gallbladder damp-heat and liver depression and spleen deficiency in patients with chronic hepatitis B.

Objective To explore the clinical characteristics and risk factors of occult pneumonia in advanced elderly patients.Methods A total of 170 advanced elderly patients with community-acquired pulmonary infection in geriatric department of Xijing hospital from January 2014 to October 2017 were enrolled.Patients were divided into two groups:the observation group (with occult pneumonia,n=80)and the control group(without occult pneumonia,n =90).Clinical data of patients were collected,and clinical characteristics and related risk factors of occult pneumonia in elderly patients were analyzed.Results There was no statistically significant difference in the positive rate of sputum culture and the distribution of pathogenic bacteria between the two groups (P ＞ 0.05).Gram-negative bacteria predominated in pathogenic bacteria.The hospitalization time was longer in the observation group than in the control group[(17.3 ± 3.0) d vs.(10.3 ± 3.9) d,P ＜ 0.05].The mortality rate was higher in the observation group than in the control group(10.0 ％ vs.3.3 ％,P ＜ 0.05).The age was older in the observation group than in the control group[(87.0± 1.7) years vs.(82.0± 2.4) years,P ＜ 0.05].The incidences of diabetes,Alzheimer's disease,hypothyroidism and long-term bed rest were higher in the observation group than in the control group (P ＜ 0.05).Multivariate logistic regression analysis showed that age (OR =6.93),dementia (OR =4.32),hypothyroidism(OR =4.89) were independent risk factors for occult pneumonia (P ＜ 0.05).Conclusions The pathogenic bacteria in advanced elderly patients with occult pneumonia are mainly gram-negative bacteria.The positive rate of CT scan confirmed-occult pneumonia is much higher than that by chest X-ray.The advanced elderly patients with occult pneumonia have longer hospitalization time and higher mortality rates.Old age,senile dementia and hypothyroidism are independent risk factors for occult pneumonia in advanced elderly patients.

Objective:To investigate the correlation between single nucleotide polymorphism of corticosteroids receptor gene(NR3C1)and children with asthma and to analyze the efficacy of inhaled corticosteroid(ICS)treatment.Methods:The study included a control group(100 healthy children)who participated in the physical examination and an asthma group(101 children with bronchial asthma)who were hospitalized in the General Hospital of the Northern Theater Command from October 2018 to October 2020.Genomic DNA was extracted from peripheral blood samples of all enrolled subjects and then the polymorphism of the glucocorticoid receptor gene locus of NR3C1 was analyzed using SNaPshot SNP gene detection technology.The comparisons of allele frequency in rs41423247、rs7701443 between two groups were performed and the treatment effects of ICS in the asthma group were evaluated at the 12th week of treatment.Results:The frequencies of GG, GC, and CC genotypes of rs41423247 locus of NR3C1 were 75.2%, 21.8%, and 3.0% in the asthma group and 72.0%, 24.0%, and 4.0% in the control group, respectively, and there were no statistically significant differences between the two groups( χ2=0.333, P>0.05). The frequencies of GG, GA, and AA genotypes of rs7701443 locus of NR3C1 were 45.5%, 39.6%, and 14.9% in the asthma group and 56.0%, 31.0%, and 13.0% in the control group, respectively, and there were no statistically significant differences between the two groups( χ2=2.259, P>0.05). After ICS treatment, the C-ACT/ACT scores were not significantly improved in children with CC genotypes at rs41423247 locus( P>0.05), while children with GG and GC genotypes were obviously improved( P<0.05). The scores of C-ACT/ACT showed obvious differences among three genotypes of rs41423247 locus after treatment with ICS( P<0.05). The C-ACT/ACT scores of all were significantly improved in children with GG, GA, or AA genotypes at rs7701443 locus after treatment with ICS( P<0.05), while there was no significant difference among those three genotypes( P>0.05). Significantly improved pulmonary function following ICS treatment in children with asthma was observed in GG and GC genotypes of rs41423247 locus of NR3C1( P<0.05), while only MMEF was improved in CC genotype( P<0.05). Meanwhile, those pulmonary function indexes were improved in all genotypes of rs7701443 after treatment with ICS( P<0.05). Conclusion:Both rs41423247 and rs7701443 locus at NR3C1 gene have polymorphisms.But there were no significant differences in the polymorphism of rs41423247 and rs7701443 locus of NR3C1 between the asthma group and the control group.Different genotype frequencies of rs41423247 and rs7701443 at NR3C1 locus in children with asthma have different effects on ICS treatment.

Objective:To investigate the relationship between rs2075748 and rs542269 single nucleotide polymorphisms of cholinergic muscarinic receptor 1 (CHRM1)gene and susceptibility of childhood asthma, as well as the differences of pulmonary function and serum acetylcholine(Ach)levels among different genotypes.Methods:A total of 156 asthmatic children who were treated in the outpatient or hospitalized in the General Hospital of the Northern Theater Command from September 2018 to September 2020 were selected as the case group, while 134 non-asthmatic children who had a healthy physical examination were selected as the control group.The SNaPshot SNP typing technique was used to analyze the genotype of the CHRM1 gene rs2075748 and rs542269 of the study subjects.Serum Ach level was detected by double antibody sandwich method, and the pulmonary function of the case group was detected.Results:After analyzing the CHRM1 gene polymorphism, it was found that the CC, CT, and TT genotype frequencies at rs2075748 were 65.4%, 28.8%, 5.8% in the case group, and 62.8%, 32.4%, 4.8% in the control group.The C and T allele frequencies were 79.8% and 20.2% in the case group, 74.3% and 25.7% in the control group.There were no significant difference in the genotype and allele frequency distribution between the two group ( χ2=2.688, 2.530, both P>0.05), and there were no significant difference in the recessive and dominant modes between the two groups ( χ2=0.338, 2.686, both P>0.05). The TT and CT genotype frequencies at rs542269 locus were 72.4% and 27.6% in the case group, 62.7% and 37.3% in the control group.The T and C allele frequency were 86.2% and 13.8% in the case group, 81.3% and 18.7% in the control group.The genotype and allele frequency distribution were not obvious different between the two group ( χ2=3.145, 2.544, both P>0.05). The risk of asthma with variant CT and TT at rs2075748 locus of CHRM1 gene were not statistically different from that of wild-type CC (both P>0.05), and the risk of asthma with variant CT at rs542269 locus was no different from that of wild-type TT ( P>0.05). The difference in FEF50% Pred and FEF75% Pred of different genotypes at rs2075748 were statistically significant( F=3.118, 4.808, both P<0.05), wild-type CC was lower than variant CT(both P<0.05). There were no statistically significant difference in pulmonary function among different genotypes at rs542269 (both P>0.05). There was significant difference in serum Ach level between different genotypes of rs2075748 ( F=4.716, P<0.05), variant CT was lower than wild-type CC ( P<0.05), variant TT was lower than wild-type CC ( P<0.05), while no significant difference was find between variant CT and TT ( P>0.05). There was no significant difference in serum Ach level between different genotypes of rs542269 ( P>0.05). Conclusion:The rs2075748 locus of CHRM1 gene is not susceptible to asthma, but it may be related to the small airway function of asthmatic children, besides there are differences in serum Ach levels with different genotypes, and the variant serum Ach level is lower.The rs542269 locus is not a susceptibility site for asthma, and there are no difference in pulmonary function and serum Ach levels in asthmatic children with different genotypes.

To explore a method for calculating water equivalent diameter () based on localizer CT images for calculation of the size specific dose estimates (SSDE).GE Revolution CT and LightSpeed VCT were used to scan CT dose index phantoms 16 cm and 32 cm in diameter at the tube voltages of 80, 100 and 120 kV to obtain the axial image and anteroposterior localizer radiograph. According to the definition of CT Hounsfield unit, the axial images were used to calculate the conversion factors that convert the phantom thickness to water equivalent thickness. The gray value of the localizer radiograph and the water equivalent thickness were calibrated with a linear equation, and the parameters of the calibration were used to calculate the water equivalent thickness. The method was verified using 2 CT dose index phantoms and in 22 patients undergoing chest and abdominal CT examination.Comparison of the water equivalent diameter () based on the localizer radiograph and axial image of the 2 phantoms showed that the percentage difference between from the axial images and from the localizer radiograph was below 3%. The trend of variations with location in the two methods was sonsistent. The difference in in intermediate region of interest between the axial image and the localizer radiograph from the 22 patients was below 6.6%. With the mean in the ROI, the maximum percentage difference was 7.5%.Calibration of the gray value of the localizer radiograph and the water equivalent thickness using the axial image and localizer radiograph of CT dose index phantoms allows quick calculation of the SSDE based on the parameters of calibration.
Calibration ; Humans ; Phantoms, Imaging ; Radiation Dosage ; Tomography, X-Ray Computed ; Water

OBJECTIVETo explore the association between urinary microalbumin-to-creatinine ratio (ACR) and brachial-ankle pulse wave velocity (baPWV) in hypertensive patients.

METHODSA total of 877 primary hypertension patients were enrolled in this trial from September 2009 to December 2012, and were randomly recruited and patients were divided into normal ACR group (ACR < 30 mg/g, n = 723), micro-albuminuria group (30 mg/g ≤ ACR < 300 mg/g, n = 136) and macro-albuminuria group (ACR ≥ 300 mg/g, n = 18). baPWV was measure by automatic pulse wave velocity measuring system.

RESULTSThe baPWV values in patients of micro-albuminuria group and macro-albuminuria group were significantly higher than in the normal ACR group (all P < 0.05). The baPWV value of macro-albuminuria group was significantly higher than in the micro-albuminuria group (P < 0.05). Linear correlation analysis revealed that ACR was positively correlated with baPWV (r = 0.413, P < 0.01). Multiple linear regression analysis showed that ACR independently correlated with baPWV in patients with primary hypertension (β = 0.29, R(2) = 0.112, P < 0.01) after adjusting for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, low density lipoprotein, high density lipoprotein and triglyceride. Using ACR < 30 mg/g and ACR ≥ 30 mg/g as dichotomous variable, binary logistic regression analysis showed that ACR ≥ 30 mg/g was also a risk factor of the ascending baPWV in primary hypertension patients (OR: 1.73, 95% CI: 1.62-2.98) after adjusting the traditional cardiovascular risk factors.

CONCLUSIONACR is positively correlated to baPWV in primary hypertension patients, and the ascending baPWV is a risk factor of early renal dysfunction in primary hypertension patients.

Albuminuria ; Ankle ; Ankle Brachial Index ; Blood Flow Velocity ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Creatinine ; urine ; Essential Hypertension ; Humans ; Hypertension ; physiopathology ; urine ; Pulsatile Flow ; Pulse Wave Analysis ; Regression Analysis ; Risk Factors