Objective To study the value of fiberoptic bronchoscopy in treatment of ventilator associated pneumonia. Methods The 168 cases of ventilator associated pneumonia in ICU were randomly divided into treatment group and control group, each group of 84 cases, were given oxygen, anti-inflammatory, expectorant treatment. Treatment group was given fiber bronchoscope sputum suction and irrigation, control group was given sputum suction tube, then we observed the oxygenation changes after sputum suction of two groups of patients, compared clinical efficacy, sputum culture positive rate, antibiotic using time and staying time in the ICU between two groups of patients. Results Compared with control group, in treatment group SaO2, PaO2 and oxygen index were significantly improved (P< 0.05) ; in treatment group CRP, PCT and IL-6 were significantly improved (P <0.05) . In the treatment group, the total effectiveness is significantly higher than the control group;antibiotic using time and staying time of ICU were obviously shorter than the control group (P< 0.05) . Conclusion Fiberoptic bronchoscopy irrigation treatment can improve oxygenation, antibiotic using time and staying time in ICU of ventilator associated pneumonia patients, and is worthy of clinical application.

AIM: To evaluate the correlation between in vitro release and in vivo absorption of aniracetam in conventional tablets and self-emulsifying drug delivery system (SEDDS), to investigate pharmacokinetics of aniracetam self-emulsifying drug delivery system and conventional tablets of aniracetam after oral administration to rats. METHODS: Dissolution behavior of these formulations was evaluated in vitro to assess the properties of dosage forms. And a new RP-HPLC method was developed for the in vivo quantitative determination of 4-p-anisamidobutyric acid (PABA), the active metabolite of aniracetam. To approach the in vitro-in vivo correlation, fraction absorbed in vivo (f) was calculated by Wagner-Nelson method, and then compared with in vitro released drug percentages (Q%). RESULTS: Aniracetam was released rapidly from SEDDS with 80%±4% of accumulation dissolution rate compared to that from conventional tablets at 15 min. The recovery of active metabolite of aniracetam was about 90%, and the intra-days and inter-day precision were within 4% and 6%, respectively. The AUC0-∞ value of aniracetam SEDDS was (11 168±2 395) ng·mL-1·h, which was about 3 folds greater than conventional tablets. The parameter MRT0-∞ of aniracetam SEDDS and conventional tablets were (2.7±0.6) h and (1.7±0.6) h, respectively, and the difference was statistically significant(P<0.05). The linear equation of in vitro-in vivo correlation for conventional tablets was obtained by regression as well. Whereas nonlinear correlation was obtained for aniracetam SEDDS, which fitted the quadric model very well and the correlation coefficient was 0.972. CONCLUSION: Aniracetam can be released faster from SEDDS than that from conventional tablets, and SEDDS improved the bioavailability of aniracetam significantly. The SEDDS composed by oil and compound surfactants which could enhance the absorption showed the expressing rate of dissolution, and those formed the o/w microemulsion with gastrointestinal liquid could absorb through lymphatic transport route.

Medicine education must pay attention to humanity education,which is determined by the nature of medicine.The present situation and problems of the medical humanity education in china were reviewed and new approaches to improve long-term mechanism of the medical humanity education in china were enhanced from the following four apects:constructing teaching staff,setting up curriculum,reforming teaching methods and building campus-culture.

Objiective To prepare pingyangmycin water-soluble wax stick and to establish its content determination method. Method The formula was optimized by orthogonal experiment and the content of pingyangmycin in wax stick was determined by high performance liquid chromatography (HPLC). Results The formula of pingyangmycin wax stick matrix was optimized as 1 g of alcohol ethoxylate and 1 g of S 40. Pingyangmycin was added when the temperature of the matrix raised to 70℃and stirred for 20 min. The linear range of pingyangmycin determined by HPLC was 34.4~172μg/mL,the regression equations was y=8298.9 x-34996(r=0.9999),and the average recovery of pingyangmycin was 102.67%(n=9). Conclusion The Preparing procedure of pingyangmycin water-soluble wax sticks is simple and stable. The HPLC method for determining the content of pingyangmycin in water-soluble wax sticks is simple, fast and accurate.

Objective To explore the methods of inducing human placenta mesenchymal stem cells (MSCs) to differentiate into insulin-producing cells. Methods MSCs were obtained from human placenta and were induced to differentiate into insulin-producing cells by activin A, epidermal growth factor (EGF), basic fibroblast growth factor (bFGF) and other cytokines. The cells were identified by immunocytochemistry staining, Western Blot and animal experiment after differentiation. Results After induction, the cells possessed some characteristics of islet βcells, and could express pancreatic duodenal homeobox-1 (PDX-1), insulin and C peptide. The induced cells could also decrease blood glucose levels of diabetic mice. Conclusions These results showed that human placenta MSCs can be induced to differentiate into insulin-producing cells by cytokines.

Objective To analyze the imaging characteristics of Von Hippel-Lindau Syndrome (VHL)typeⅠ.Methods 12 patients diag-nosed as VHL type Ⅰ were collected and all the patients had underwent 3.0T MRI and 64-slice spiral CT plain and enhanced scan. Imaging data was analyzed by two senior radiologists to summarize its imaging featueres.Results Multiple hemangioblastomas (HGBLs)in cerebellum,spinal cord or brainstem were seen in all the patients.Flow void effect with varied degree was seen in the lesions.Dilated feeding and drainage blood vessels around lesions was seen in 6 cases.Multiple kidney and pancreas cysts were seen in all the patients.There were 4 cases with syringomyelia,7 cases with ocular retinal angioma,5 cases with renal cell carcinoma,2 cases with ground-glass-like lesions and micronodulars in lung.Conclusion VHL type Ⅰ has complex imaging performance.Ima-ging examination is important for early detection of VHL disease.

Nowdays, Chinese medicine training has two modes, apprentice education and college education. The two modes showed the differences in the source of students, teaching content, methods and effect of the education. The two models should be combined to cultivate excellent talents of Chinese Medicine. Additionally, different training should be conducted according to different goals. This article focused on the traning mode of Chinesae medicine talents at Beijing University of Chinese Medicine in recent years, put forward some issues in future education and provided some promoting strategies to combine traditional apprentice education and college education.

Electrophoresis, Capillary ; methods ; Humans ; Micelles ; Paraquat ; blood

Objective:To study the curative efficacy of metformin combined with Jinlida granules in the treatment of gestational diabetes mellitus and its effects on the serum vascular endothelial growth factor (VEGF),adiponectin (APN) and homocysteine(Hcy) levels.Methods:94 patients of gestational diabetes mellitus who were treated from July 2014 to July 2016 in our hospital were selected.According to random number table,those patients were divided into the observation group (n=47) and the control group (n=47).On the basis of routine treatment,such as control diet,reasonable exercise and healthy diet,etc,the control group was treated with metformin,while the observation group was combined with Jinlida granules on the basis of the control group.The changes of blood glucose,blood lipid and serum VEGF,APN and Hcy before and after treatment were compared between the two groups,the incidence of maternal complications and neonatal adverse outcomes were compared.Results:Compared with before treatment,the blood glucose,blood lipid of both groups after treatment were significantly improved (P ＜0.05),the fasting plasma glucose (FBG),postprandial 2h blood glucose (2hPG),glycosylated hemoglobin (HbAlc),total cholesterol (TC),triacylglycerol (TG),low density lipoprotein cholesterol(LDL-C) of observation group were significantly lower than those of the control group,the serum high density lipoprotein cholesterol (HDL-C) level was significantly higher than that of the control group(P＜0.05);after treatment,the serum VEGF,APN and Hcy levels were significantly improved than those before treatment in both groups (P＜0.05),and the serum VEGF,and Hcy levels of observation group were lower than those of the control group,the serum APN level was higher than that of the control group (P ＜ 0.05);the incidence of gestational hypertension,hydramnios,cesarean section and premature delivery of observation group was significantly lower than that of the control group (P ＜0.05);the incidence of giant child,neonatal Jaundice and neonatal respiratory distress in the observation group was significantly lower than that of the control group (P＜0.05).Conclusion:Metformin combined with Jinlida granules was effective for the gestational diabetes mellitus,which could effectively control the blood glucose,blood lipid levels and might be related to the regulation of serum VEGF,APN and Hey levels.

Objective To discuss human papilloma virus(HPV)prevalence and HPV genotypes distribution and the infection factors,to provide scientific guidance for the prevention and treatment of cervical cancer.Methods From March to November in 2009,605 women received cervical HPV testing in the Tumor Hospital of Harbin Medical University,to obtain specimens of cervical cytology,rapid flow-through hybridization technique (namely Hybribio flow-through hybridization)was used to detect HPV genotypes simultaneously.Single-factor and multivariate factors non-conditional Logistic regression analytic method was used to discuss the relationship between HPV infection of females and age,marital condition,level of education,level of income,occupation,initial age for sex,contraception,number of pregnancies,delivery approach and smoking.Results HPV infection rate was 21.49%(130/605),the positive rate of HPV infection in high-risk subtypes was 15.70%(95/605),the most common type was 5.29%(32/605)in the samples.Single factor non-conditional logistic regression model analysis showed that initial age for sex was the risk factor(X2=4.4618,P<0.05),HPV prevalence increased with a lower initial age for.sex reduced.But there was no significant difference in age,marital condition,education,income,occupation,contraception,number of pregnancy,delivery approach and smoking teams(X2=0.0525,1.8510,1.0348,0.2592,1.1176,1.5664,2.8835,1.4597,2.6161,all P>0.05).The analysis of multivariate factors nonconditional Logistic regression showed that the age of initially having sex,marital status and number of pregnancies were the risk factors(X2=21.6637,8.0574,15.7573,all P<0.05).Conclusions The risk factors for HPV infection are mainly about having sex too young,marital status and number of pregnancies,attention should be paid to screening for HPV.