Objective To assess the efficacy of pulmonary surfactant on acute lung injury.Methods The randomized controlled study involving pulmonary surfactant on acute lung injury were identified from Cochrane Library,PubMed,China Academic Journals Full-text database,Chinese Biomedical Literature Database and Chinese Journal Full-text database.According to inclusion and exclusion criteria,the quality of papers were evaluated and then extract the valid data for meta-analysis.Results The current study included 5 English papers,including 1219 cases of patients.Meta analysis showed that:(1) There was no significant difference between experimental group and control group in term of mechanical ventilation(WMD =-1.08,95％ CI(-3.00,0.85),P =0.27).(2) Two studies conducted the ICU time comparison and there was no difference in experimental group and control group(WMD =-0.61,95％CI(-4.63-3.41),P =0.77).(3) Three studies were conducted the survival rates and no difference had found regarding of survival rates between experimental and control group (RR =1.41,95 ％ CI(0.94-2.11),P =0.10).Conclusion The existing clinical evidences showed the addition of pulmonary surfactant have no significant effect regarding of mechanical ventilation time,ICU length of stay and survival rate in patients with acute lung injury compared with conventional therapy However,due to the quality and the limitations of the studies and selection bias and measurement bias,it was needed more high-quality,large-scale randomized controlled clinical studies to validate.

OBJECTIVE: To evaluate the curative effect and costs of sequential therapy with cefuroxime for lower respiratory bacterial infection.METHODS: A total of 180 patients with lower respiratory bacterial infection were randomly divided into 3 groups: persistent intravenous drip group,sequential therapy group,and per os group.The therapeutic effects and the adverse drug reactions of the three groups were observed,and the data were subjected to cost-effective analysis in pharmacoeconomics.RESULTS: In persistent intravenous drip group,sequential therapy group,and per os group,the costs were(1 673.00?183.85),(1 268.10?112.25) and(994.80?102.65) yuan,respectively, the clinical effective rates were 93.33%,89.66%,and 69.35%,respectively,the cost-effectiveness were 1 792.56?196.97,1 414.34?125.20,and 1 434.46?109.79,respectively,and the incremental cost-effective ratios were in the intravenous drip group and sequential therapy group were 2 828.19?338.62 and 1 345.64?47.27,respectively as against per os group.CONCLUSION: Among the schemes,sequential therapy is the optimal one.

Objective To evaluate the prognostic role of bispectral index (BIS) monitoring in patients after cardiopulmonary resuscitation (CPR) in the intensive care unit (ICU).Methods Thirtythree adult patients after CPR were enrolled and divided into survived group and non - survived group as per 7-day survival.During their stay in the ICU,BIS and SaO2 (saturation of artery oxygen) levels of all the patients were continuously monitored.The neurological status of the patients was measured with Glasgow coma scale (GCS).Acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) was used to evaluate the patient condition. SjO2 (saturation of jugular bulb venous oxygen ) levels of 23 patients were continuously monitored and then the difference in values between SaO2 and SjO2 was calculated to show oxygen metabolism in the brain. The studied variables were compared between the two groups. The correlations between BIS values and GCS scores,and between BIS and APACHE Ⅱ scores were respectively analyzed. Results The BIS values and difference in values between the SaO2 and SjO2 were significantly higher in the patients of survived group than those in the patients of non-survived group (P ＜0.01 ).There were positive correlation between BIS and GCS (r =0.821,P ＜ 0.01 ) and as well as positive correlation between BIS and APACHE- Ⅱ ( r =0.434,P ＜ 0.05 ).Conclusions The BIS may be useful to predict the post - resuscitative outcome of patients after cardiopulmonary resuscitation.

【Objective】To observe the effect of Zhuyun Prescription Ⅲ(ZPⅢ),which is composed of kidney-tonifying and spleen-strengthening herbal medicine,on T lymphocyte antigen recognition receptors(TCR?&T) in luteal insufficiency abortion rats with deficiency of kidney.【Methods】Forty SD rats were equally randomized into 5 groups: blank control group,model group,high-and low-dose ZPⅢ groups(in the doses of 7.08 and 3.54 g?kg-1?d-1,respectively) and allylestrenol tablets(1.5 mg?kg-1?d-1) group.Luteal insufficiency abortion rats model with deficiency of kidney was established by hydroxyurea(450 mg?kg-1)and mifepristone(3.75 mg?kg-1).The uterus weight,the amount of embryo and the abortion rate were observed,and the peripheral blood levels of TCR?&T and CD3+T lymphocytes were detected with flow cytometer.【Results】The uterus weight and the amount of embryo were decreased,and the abortion rate was increased in the model group(P

Objective To investigate the value of thyroid transcription factor-1(TTF-1) in the diagnosis and biological behavior assessment of hepatocellular carcinoma (HCC). Methods Thirty liver specimens obtained from benign lesions were analysed, among which 25 were hepatic cirrhosis and inflammatory diseases, and the other 5 were adenomas. And there were 176 specimens of liver tumors, among which 142 were HCC (well differentiated, n=12; moderately differentiated, n=57; poorly differentiated, n=73), 17 were intrahepatic cholangiocellular carcinoma (ICC) and the other 17 were liver metastatic carcinoma (MC). The expression of TTF-1 was examined immunohistochemically in the above tissues, and the difference in expression of TTF-1 among different tissues was examined by Fisher's exact test, Kruskal-Wallis test and Spearman rank correlation analysis. Results TTF-1 was significantly expressed in the cytoplasms of all the hepatocytes besides tumors and liver benign lesions. The expression rate of TTF-1 in HCC was 78.9% (112/142), however, TTF-1 was negatively expressed in ICC and MC(P

Objective To investigate the role of asctrocytes in the process of chronic degeneration of dopaminergic neurons in intracephalic inflammation rat model induced by intracerebroventricularly injection of lipopolysaccharide.Methods Sixty healthy male SD rats were assigned into lipopolysaccharide group or saline control group randomly.All injections were made intracerebroventricularly on right side of the rats.Ethovison software was used to measure the movement distance of rats within 30 minutes.Specific antibody for glial fibrillary acid protein (GFAP) was used in immunohistochemistry stain to detect the changes of asctrocytes in the substantia nigra of rats.Results Movement distance of lipopolysaccharide-injected rats decreased by 21.2% compared with saline-injected rats at 16 weeks after injection (t=2.54,P<0.05)by 27.0% (t=3.55,P<0.01) at 24 weeks and by 31.4% (t=3.91,P<0.01) at 28 weeks after lipopolysaccharide injection.The asctrocytes were activated obviously in the substantia nigra of lipopolysaccharide-injected group at 2 weeks,while the numbers of GFAP-positively stained cells (228.60 + 22.35) increased significantly compared with saline-injected group ( 165.20 ± 25.97) (t = 4.14,P< 0.05).The activation of asctrocytes was not found in lipopolysaccharide-injected group at 4 weeks and 12 weeks.The asctrocytes were re-activated in the substantia nigra of lipopolysaccharide-injected group at 24 weeks,while the numbers of GFAP-positively stained cells (220.00±21.01 ) increased significantly compared with saline-injected group (169.00± 19.00) (t= 4.03,P<0.05).The activation of asctrocytes was not seen at any time point in saline-injected group.Conclusions Intracephalic inflammation induces chronic degeneration of substantia nigral dopaminergic neurons in rats.The asctrocytes exhibite "acute activation-quiescing-reactivation" state,indicating that they might be involved in the mechanism of dopaminergic neurons degeneration.

ObjectiveTo investigate the therapeutic effects of patients with non-acquired immunodeficiency syndrome ( AIDS )-related cryptococcal meningitis treated with fluconazole and flucytosine.MethodsA retrospective study was conducted including 52 cases of non-AIDS-related cryptococcal meningitis,which were divided into two groups:the amphotericin B combined with flucytosine group (n =32) and the fluconazole combined with flucytosine group (n =20 ). The comparison between groups was done by t test and chi-square test.ResultsThe intracranial pressure of the amphotericin B combined with flucytosine group and the fluconazole combined with flucytosine group were (221.9±76.2) and (213.4±99.2) mm H2O,respectively (t=0.302,P＞0.05) ; the cryptococcus counts in the cerebrospinal fluid (CSF) were (351 ± 1180) and (508 ± 943)/mL,respectively (t=- 0.473,P＞0.05) ; the CSF protein levels were (0.754 ± 0.726) and (0.649 ±0.308) g/L,respectively (t=0.578,P＞0.05) ; the CSF white blood cell (WBC) counts were (16±25) × 106/L and (28±32) × 106/L,respectively (t=-1.348,P＞0.05).The cured rates were 59.38％ (19/32) and 35.00％ (7/20),respectively in the amphotericin B combined with flucytosine group and the fluconazole combined with flucytosine group,and the improved rates were 6.25％(2/32)and 25.00％ (5/20),respectively,the uncured or mortality rates were 34.38％ (11/32) and 40.00％ (8/20),respectively,and the difference were not significant of cured rates (x2 =2.925,P＞0.05) and uncured or mortality rates (x2 =0.168,P＞0.05) between two groups.ConclusionFluconazole combined with flucytosine also has a good effect on the treatment of cryptococcal meningitis.

Objective To explore the efficacy of sequential or combined amphotericin B (AmB) and fluconazole (FCZ) therapy on a 5 flucytosine based regimen in non-acquired immunodeficiency syndrome (AIDS)-related cryptococcal meningitis.Methods A tatal of 117 cases of non-AIDS-related cryptococcal meningitis treated with 5-flurocytosine-based regimens were retrospectively divided into five groups:AmBgroup (n=38),FCZ group (n=25),FCZ and AmB sequential group (n=18),AmB and FCZ sequential group (n=15),AmB and FCZ combination group (n=21).The number in cerebrospinal fluid (CSF) of the five groups were compared.Statistical analyses included t test,oneway analysis of variance,K-independent samples test and chi-square test.Results Intracranial pressure of AmB group,FCZ group,FCZ and AmB sequential group,AmB and FCZ sequential group,AmBandFCZ combination group were (208.6±75.1),(191.5±94.5),(185.0±76.3),(201.9±69.7) and (223.1±89.3) mm H2O (1 mm H2O=0.0098 kPa),respectively,and the differences were not statistically significant (F=0.611,P =0.656).Median cryptococcus counts in CSF of the five groups were 0,10,0,3 and 0/mL,respectively,with no statistical significance (x2 =7.638,P-0.090).CSF protein levels of the five groups were 0.55,0.69,0.67,0.53 and 0.96 g/L,respectively,with no significant differences among groups (F=7.063,P=0.133).The cure rates of the five groups were 55.3％ (21/38),32.0％ (8/25),9/18,6/15 and 47.6％ (10/21),respectively;progression rates or mortality of the five groups were 28.9％ (11/38),44.4％ (11/25),5/18,4/15and 23.8％ (5/21),respectively; and the differences among cure rates (x2 =3.638,P=0.457) and progression rates or mortality (x2-2.785,P =0.604) were not statistically significant.Conclusion FCZ or AmB alone,sequential or combined therapy were all effective in the treatment of cryptococcal meningitis.

OBJECTIVETo explore the effect differences between twirling-rotating reinforcing and reducing technique of acupuncture on cardiac damage in spontaneous hypertensive rats (SHR).

METHODSSixty male 11-week-old SHR were randomly divided into four groups: a model control group (group A), a twirling-rotating reinforcing technique group (group B), a twirling-rotating reducing technique group (group C) and a needle retaining group (group D), 15 rats in each one. In addition, twelve male 11-week-old Wistar rats were used as a blank control group (group E). Acupuncture was not used in group A and group E, only with grasp, capture and binding stimulation that was also adapted in the rest groups. Rats in the group B were treated with acupuncture at "Taichong" (LR 3) by twirling-rotating reinforcing technique for 1 min and then the needles were retained for 9 min; rats in the group C were treated with acupuncture at "Taichong" (LR 3) by twirling-rotating reducing technique for 1 min and then the needles were retained for 9 min; rats in the group D were treated with acupuncture at "Taichong" (LR 3) but without any technique and then needles were retained for 10 min. Before and after acupuncture, blood pressure monitor was used to measure the rats' systolic pressure and diastolic pressure every 6 days. Twenty-eight days after the treatment, HE and Masson staining were adopted to observe the status of left ventricular hypertrophy and myocardial fibrosis. ELISA method was applied to test the content of endothelin-1 (ET-1). PCR semiquantitative method was used to analyze Type I and III collagen mRNA in the left ventricular.

RESULTS(1) Blood pressure: after the treatment, the systolic pressure and diastolic pressure were both increased in the group A and the group B (P < 0.05); while the two pressures were both lowered in the group C and the group D (P < 0.05), which was more obvious in the group C (P < 0.05). (2) According to HE and Masson staining, except for the group E, the myocardial hypertrophy and fibrosis could be found in the rest groups, in which the group C was the modest, followed by the group D, while the group A and the group B were more severe. (3) Concentration of ET-1: there were differences of concentration of ET-1 among 5 groups (P < 0.05), and the concentration value from high to low was the group A, B, C, D and E. (4) Type I collagen mRNA: the difference of level of Type I collagen mRNA between group C and D was not statistically significant (P > 0.05); compared with the group A and B, the level was lower in the group C; the level was the lowest in the group E. Type III collagen mRNA: the difference between the group A and B was not statistically significant (P > 0.05); compared with the group A, B and D, the level was lower in the group C.

CONCLUSIONThe twirling-rotating reducing could reduce the systolic pressure and diastolic pressure in SHR, effectively prohibit the production of ET-1 and expression of Type I and III collagen mRNA, and it has more obvious inhibiting effect on Type III collagen mRNA. There is biological effect difference between twirling-rotating reinforcing and reducing technique.

Acupuncture Therapy ; instrumentation ; methods ; Animals ; Collagen ; genetics ; metabolism ; Endothelin-1 ; genetics ; metabolism ; Heart Ventricles ; metabolism ; pathology ; Humans ; Hypertension ; genetics ; metabolism ; pathology ; therapy ; Male ; Rats ; Rats, Inbred SHR ; Rats, Wistar

Objective To investigate the long-term effect of inflammation on behavior,microglias and dopaminergic (DA) neurons in the substantia nigra of intracephalic inflammation rat models induced by intracerebroventricular injection of low-dose(10μg) lipopolysaccharide (LPS).To analyze the relationship between activation of microglias and DA neurons degeneration in order to explore the mechanism of inflammation in the progressive process of Parkinson' s disease (PD).Methods 50 healthy male SD rats were randomly assigned into saline-injected control group and 10μg LPS-injected group.All injections were made intracerebroventricularly on right side of rats with saline or LPS.Moving speed was measured at different time points.At 24 weeks and 40 weeks after saline or LPS injection,specific antibodies of OX-42 and OX-6 were used separately to detect the changes of microglia in the substantia nigra of rat.The changes in morphology and numbers of substantia nigra DA neurons were observed by tyrosine hydroxylase(TH) immunohistochemical staining.The expression and distribution of the degenerated neurons in substantia nigra were detected by using Fluoro-Jade B(FJB).Results ①Analysis of moving speed sho wed that the moving speed of 10μg LPS-injected group rats and saline-injected group rats was similar from 4 weeks to 36 weeks after injection.At 40 weeks post injection,moving speed of 10μg LPS-injected group rats decreased by 24.6％ compared with that of saline-injected group rats (P＞ 0.05 ).②At 24 weeks and 40 weeks after injection,there were many activated OX-42 positive microglias in the substantia nigra of 10μg LPS-injected group rats,but there was almost no significant activated OX-42 positive microglia in saline-injected group.OX-6 positive microglias were not found in the substantia nigra of both of two groups.③At 24 weeks and 40 weeks post injection,the number of TH-positive neurons in the substantia nigra of 10μg LPS-injected group rats decreasedby 24.2％ ( t=4.803,P＜0.01) and 27.6％ ( t=3.212,P＜0.01) respectively compared with those of salineinjected group.④ There was no FJB positive neurons in the substantia nigra of the two group rats.Conclusion Intraventricular injection of low-dose LPS ( l0μg) in rats may induce long-term activation of microglias and chronic degeneration of DA neurons in the subs tantia nigra of rats although the necrosis are not occurs to DA neurons till 40 weeks post LPS injection.Intraventricular injection of low-dose LPS in rats could be ideal model to study the mechanism of chronic degeneration of DA neurons in PD.