Objective To investigate the effect of nikethamide combined with noninvasive ventilator in the treatment of chronic obstructive pulmonary disease ( COPD) complicated with respiratory failure.Methods 127 cases with COPD complicated with respiratory failure in our hospital from February 2014 to March 2016 were selected and randomly divided into observation group (72 cases) and control group (55 cases), the control group was treated with noninvasive ventilator therapy, and the observation group was treated with the therapy of nikethamide on the basis of the control group, the therapeutic effect, blood gas changes, etc of two groups were observed.Results The effective rate of the observation group was 80.56%, significantly higher than that of the control group (63.64%), the difference was statistically significant (P<0.05), the observation group after treatment 24h and 72 h pH and oxygen partial pressure (PaO2) were significantly higher than the control group, while the carbon dioxide partial pressure (PaCO2) was significantly lower than the control group, the difference was statistically significant (P<0.05), after treatment 24h and 72 h APACHE II scores in the observation group were (20.20 ±2.71) and (18.01 ±1.16), significantly lower than that of the control group, the difference was statistically significant (P<0.05), the hospitalization time, tracheal intubation rate and mortality rate of the observation group were (14.82 ±4.61) d, 11.11%and 4.17%, which were significantly less than those in the control group, the difference was statistically significant ( P <0.05 ) . Conclusion Noninvasive ventilator combined with nikethamide in the treatment of COPD combined with respiratory failure , can improve the effect of noninvasive ventilation, reduce the rate of tracheal intubation in patients.

The most common neurological clinical manifestations of refeeding syndrome(RFS)are seizures and altered consciousness. This article presents a case in which central pontine myelinolysis(CPM) is a complication of RFS and describes its diagnosis and treatment process. This case highlights the importance of early cranial MRI examination to exclude CPM in patients with persistent hypoghosphatemia and altered consciousness during the course of RFS treatment.

Objective:To explore whether barium chloride (BaCl 2) preconditioning has the protective effect on lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) model in mice and the possible mechanism. Methods:Sixty 8-12 week old healthy C57BL/6 male mice were randomly divided into control group, ARDS model group and BaCl 2 pretreatment group, with 20 mice in each group. The BaCl 2 pretreatment group was continuously injected with BaCl 2 (4 mg/kg through the tail vein) for 3 days before ARDS model establishment. ARDS model was established by intratracheally injecting (3 mg/kg) LPS. The control group was intratracheally given the same volume of 0.9% normal saline. On 24th hour after ARDS model establishment, some mice were sacrificed for obtaining fresh lung tissue. And the right lower lobe of the lung was separated for observing the pathological changes of lung tissue while the left lung tissue was used to measure the wet/dry weight ratio (W/D) of the lung. Some mice were sacrificed for observing pulmonary microvascular permeability at 2nd hours after injecting Evans blue (EB) through tail vein. The left mice were killed for alveolar lavage to measure the levels of tumor necrosis factor-α (TNF-α) via enzyme linked immunosorbent assay (ELISA). Results:Comparing with the control group, ARDS model group showed typical ARDS pathological changes, which included the increased W/D ratio (4.951±0.161 vs. 3.449±0.299, P < 0.01) and the content of EB in the lung tissue (μg/g: 0.130±0.027 vs. 0.085±0.011, P < 0.01), the damaged alveolar wall structure, lung congestion and exudates in the alveoli, as well as amounts of inflammatory cells. The pathological score of lung injury (10.33±1.15 vs. 1.67±0.58) and the level of TNF-α in BALF (ng/L: 900.85±247.80 vs. 68.21±5.79) were significantly increased in the ARDS model group (both P < 0.01). Comparing with the ARDS model group, the lung W/D ratio (4.620±0.125 vs. 4.951±0.161) and the EB content in the lung tissue (μg/g: 0.108±0.011 vs. 0.130±0.027) of BaCl 2 pretreatment group were significantly reduced (both P < 0.01). And the damaged pulmonary structural BaCl 2 pretreatment group were significantly alleviated. In addition, the pulmonary pathological score (5.00±1.00 vs. 10.33±1.15) and the level of TNF-α in BALF (ng/L: 169.16±73.33 vs. 900.85±247.80) were significantly decreased (both P < 0.01). Conclusion:Barium chloride pretreatment can improve the lung histopathological changes of ARDS model mice induced by LPS by reducing the permeability of pulmonary capillaries and local inflammatory reaction.Barium chloride has the protective effect against LPS attack in mice model of ARDS.

Through the analysis of laws and policies related to registration self-inspection, visiting and researching enterprises, holding symposiums, and issuing nationwide questionnaires, the risks in the registration self-inspection process were summarized, analyzed, and evaluated. From the aspects of regulatory departments and manufacturing enterprises, we suggest to improve China's medical device registration regulations system and reduce the risks of all parties in the registration self-inspection work.
Risk Management ; Commerce ; Medical Device Legislation

Type inspection is a necessary precondition of technical evaluation of medical device. The implementation of The Provisions for Administration of Self-Test for Medical Device Registration facilitates the registration pathway for applicants. How to improve the effectiveness of registration self-test has drawn attention from many stakeholders. In this study, we analyzed and discussed the factors affecting the validity of registration self-test from technical evaluation perspective, and proposed suggestions for improvement accordingly. The aim of this article is to boost the reliability and effectiveness of registration self-test and offer a reference for applicants to carry out registration self-test.
Medical Device Legislation

OBJECTIVE：To optimize the processing technology of Paeonia lactiflora stir-baked with wine ，and to investigate its in vitro anticoagulant effect. METHODS ：The weight coefficient of each index was determined and the comprehensive score was calculated with analytic hierarchy process （AHP），Criteria Importance Though Intercrieria Correlation （CRITIC）and AHP-CRITIC weighting method ，using the contents of oxypaeoniflorin ，albiflorin，paeoniflorin，benzoic acid and water-soluble extract as index. Box-Behnken response surface methodology was used to optimize the parameters of P. lactiflora stir-baked with wine ，such as moistening time ，frying time and frying temperature. Then in vitro anticoagulant experiment was used to investigate the pharmacodynamics of P. lactiflora stir-baked with wine prepared according to the optimal processing technology. RESULTS ：The weight coefficients of albiflorin ，oxypaeoniflorin，paeoniflorin，benzoic acid and water-soluble extract determined by AHP-CRITIC weighting method were 0.233 9，0.131 7，0.183 3，0.078 9，0.372 3，respectively；the optimal processing technology of P. lactiflora stir-baked with wine included moistening time of 35 min，frying time of 20 min and frying temperature of 120 ℃. The results of in vitro anticoagulant test showed that P. lactiflora and P. lactiflora stir-baked with wine could significantly prolong the time of thrombin time ，prothrombin time ，activated partial thrombin time of plasma ；the effects of P. lactiflora stir-baked with wine were significantly better than those of P. lactiflora （P＜0.05）. CONCLUSIONS ：The optimized processing technology of P. lactiflora stir-baked with wine is stable and feasible. The in vitro anticoagulant effect of P. lactiflora stir-baked with wine prepared by this tehcnology is better than that of raw products.