Objective To explore the clinical effect of application of mechanical insufflation-exsufflation (MI-E) for airway mucus clearance in patients with artificial airway.Methods 72 patients were divided into the observation group (36 cases) and the control group (36 cases)according to admission order by random number table.All subjects were given with individual treatment and nursing,while the control group was given with the application of rock sputum ejection machine twice per day,the observation group was given with application of both cough assist and rock sputum ejection machine for sputum excretion.The clinical effect of airway mucus clearance after 5 days' treatment was compared between two groups.Results Compared with the control group,oxygenation index after 5 days' treatment in the observation group increased [(48.16±9.57) kPa vs.(37.99±14.67) kPa,t=-3.48,P＜0.01],clinical pulmonary infection score [(3.39±0.77) scores vs.(5.33±1.47) scores] and procalcitonin level [0.10 (0.07,0.27) μg/L vs.0.43 (0.12,0.79) μg/L] were lower (t=-7.02,Z=-3.28,P＜0.01),the mean sputum amount was bigger [(3.64±0.43) ml vs.(2.31 ±0.44) ml] (t=-4.84,P＜0.01),and the mean interval of suction was longer [(97.81 ±7.28) min vs.(82.00±8.88) min](t=-3.08,P＜0.05).Conclusions MI-E can clear the airway secretion effectively so as to improve oxygenation and the inflammatory markers.And MI-E is a simple,noninvasive and safe technique.

The epidemic tendency of dental caries of school students over the past 15 years in China was analyzed in order to provide bases for prevention of dental caries. Data sets of boys and girls at the age of 7, 9, 12 years (deciduous caries) and 7, 9, 12, 14, 17 years (permanent caries) were collected from the series of Chinese National Surveillance on Students' Constitution and Health (CNSSCH) between 1991 to 2005, a survey that covers 30 provinces of and autonomous regions of China, with Tibet Autonomous Region and Taiwan Province excluded owing to unavailability of related data. According to their socioeconomic status, three urban regions and three rural regions (province capital must be included) were selected in each province, where its socioeconomic status and sports exercise can represent the general level of the locality. All subjects were Han students. Prevalence of deciduous and permanent caries was measured. In 2005, the prevalence of deciduous caries at 7, 9, 12 years was 52.87%, 52.04% and 9.80% in urban boys, 59.37%, 58.68% and 12.18% in rural boys, and that of permanent caries in boys at 7, 9, 12, 14, and 17 years was 2.35%, 5.63%, 13.94%, 19.05% and 21.29% in urban boys, 3.42%, 7.26%, 13.35%, 16.16%, 18.55% in rural boys, while in girls at the same age groups, the prevalence of deciduous caries was 53.53%, 49.48%, 7.92% in urban girls, 59.95%, 56.13%, 8.85% in rural girls; the prevalence of permanent caries was 3.61%, 8.99%, 19.32%, 24.75%, 28.62% in urban girls, and 3.47%, 10.65%, 17.66%, 22.52%, 24.27% in rural girls. The epidemic manifested a gradient distribution in age groups, which was closely related to region of the study population. A dramatic decreasing trend was witnessed among all sex-age subgroups in the rural groups between 1990 and 2005, and such a trend was stronger in deciduous caries than in permanent caries, however, this kind of decreasing trend was not steady, because there was bounce during some year. Although the morbidity of dental caries in China is lower than the standard set by the World Health Organization, and the prevalence of dental caries decreased from 1991 to 2005, the prospect of epidemic dental caries in China is in no way optimistic. The total population with dental caries is still very large and the prevalence decreased unstably. Therefore, financial support on school oral health care should be increased, and a national school oral health service network should be set up.

Objective To investigate the application effect of nasal gastrointestinal double lumen catheter tube placement with air insufflation in mechanically ventilated patients with intra-abdominal hypertension.Methods A total of 20 patients with intra-abdominal hypertension were randomly divided into control group and observation group (n=10 in each group).Patients in control group received indwelling nasogastric tube for decompression and indwelling nasal intestine tube by air insufflation for enteral nutrition support .Patients in observation group received the dual lumen gastrointestinal tube for decompression and enteral nutrition support.The time required for catheterization,changes in intra-abdominal pressure before and after air insufflation,catheter success rate at one attempt,pain scores of patients to catheter operation, duration of decompression,enteral nutrition start time and the duration of mechanical ventilation were compared between two groups.Results The time required for catheterization,catheter air insufflation volume in observation group were significantly lower than those in control group (P <0.01);pain scores of patients to catheter operation were significantly lower in observation group than those in control group (P <0.01);There was no significantly difference in once catheter success rate,changes in intra-abdominal pressure before and after catheterization,abdominal high pressure relief time ,enteral feeding start time, and duration of mechanical ventilation between the two groups (P >0.05 ).Conclusions The technique of air insufflation has higher success rate for Indwelling nasal intestine tube in mechanically ventilated patients with intra-abdominal hypertension,and this method is safe and reliable,dual lumen gastrointestinal tube can improve patients'comfort,shorter catheterization time and reduce catheter air insufflation volume.

Objective To evaluate the effects of arterial pressure continuous output (APCO) derived from stroke volume variation (SVV)-guided fluid management in the patients undergoing supratentorial neoplasms surgery.Methods Sixty-three patients (29 males, 34 females, aged 18-65 years, ASA physical status Ⅰ or Ⅱ) undergoing elective supratentorial neoplasma surgery were randomly divided into control group (group C, CVP-guided fluid management, n=30) and GDT group (group S, SVV-guided fluid management, n=33).Before the induction of general anesthesia, the hydmxyethyl starch Voluven (130/0.4) bolus 3 ml/kg in the two groups was administered followed by infusion of crystalloid at the rate of physical requirement.Hydroxyethyl starch or vasoactive agents were administrated to achieve the goal of CVP≥8 mm Hg or MAP>80% of baseline in group C andto reach the value of SVV≤12% and MAP>70% of baselinein group S.Intraoperativecrystal, intraoperative colloids,total fluid volume, bleeding volume, volume of blood transfusion and urine volume were recorded.The radial artery and venous blood was sampled for blood gas analysis, measurement of lactate concentration and laboratory parameters at 30 min before anesthesia induction (T0), the dura mater cutted (T1), end of operation (T2) and postoperative 24 h (T3).Postoperative complications and the number of patients with complications in postoperative period, the length of ICU stay and postoperative days were assessed.Results Total infused fluid volume [(1 478±312) ml vs (1 183±294) ml] and intraoperative colloids [(775±236) ml vs (487±243) ml] were significantly higher in group S than those in group C (P<0.05).Compared with T0, the lactate concentration were decreased significantly in two groups at T1 and T2.The lactate concentration in group S was significantly lower than group C at T2 [(0.91±0.25) mmol/L vs (1.31±0.46) mmol/L](P<0.05).There was no significant difference of postoperative complications, the length of ICU stay and postoperative days between two groups.Conclusion Fluid management guided by SVV during supratentorial neoplasms surgery reduces lactate levels.

Objective:To evaluate the effect of humanistic care for medical care integration on quality of life in elder patients with mild cognitive impairment. Method:Seventy patients with mild cognitive impairment in our hos-pital were randomly divided into experimental group ( n=35 ) and control group ( n=35 ) using random number ta-ble. The patients in the control group were given routine care, while those in the experimental group were given hu-manistic care for medical care integration and home visiting once a month besides routine care. All the patients were evaluated by the Montreal Cognitive Assessment Scale ( MoCA) , Activities of Daily Living ( ADL) , and the MOS Item Short from Health Survey ( SF-36 ) during hospitalization, three months and six months after hospital discharge. Result:Three and six months after hospital discharge, the scores of these three scales of all subjects in two groups were significantly higher than those during hospitalization ( P<0 . 05 ) . The scores of the subjects in the experimental group also significantly higher than those of the control group, and the differences were statistically significant (P<0. 05). Conclusion: For the elder patients with mild cognitive impairment, humanistic care for medical care integration can significantly improve the cognitive function, self -care ability and quality of life. Therefore, it is worthy using in clinical treatment.

Objective To systematically evaluate the application of problem-based learning (PBL)in the teaching process of health management major in China.Methods Databases including CNKI (1979 to December the 2015),VIP (1989 to December the 2015),Wanfang (1982 to December the 2015) and PubMed were systematically retrieved.Any literature about PBL of health management major was included.Seffdeveloped data extraction form was used for collecting the information.Data were input and analyzed using Excel 2007.Results 15 papers were included in the analysis.The first author mainly came from the northeast region of China (7).Most (10) papers did not get the funding support.No paper was published in the journals contained in the Guide to the Core Journals of China.6 papers of experimental studies compared the performance difference of students of the PBL and lecture-based learning (LBL),which was statistically significant.Conclusion PBL is superior to the LBL.However,due to the large difference in the quality of literature,more studies were needed to determine the effect of PBL.Moreover,we should pay attention to the combination of PBL and LBL.

Objective: To observe the effect of chronic psychological stress on change of function of learning and memory, and CD4, and CD8 in mice. Methods: 50 BALB/c mice were randomly divided into control group and immobilization stress group (n=25 in each group). The mice mode of stress was made by restraint for 6 hours per day. Suspend tail test was performed on change of behaviors in mice. RIA was employed to measure levels of neuropeptide Y in the brain. Results: Compared with the control group, the mean escape latency of the mice in the chronic restraint groups was longer than that of the control mice (P

OBJECTIVE: To analyze 113 patients with drug-induced liver disease(DILD) so as to clinically validate the international generally-accepted diagnostic criteria.METHODS: 113 DILD cases were reviewed and categorized according to international generally-accepted diagnostic criteria and then graded separately by Maria clinical scale and DDW-J scale to analyze the correlations.RESULTS: 113 out of 822 patients with liver diseases were DILD(13.7%),among whom 17 were of hepatocellular type(15.0%),92 cholestasis type(81.5%) and 4 mixed type(3.5%).Application of Maria clinical scale and DDW-J scale led to different number of DILD cases diagnosed.DILD were mostly induced by antihyperlipidemic drugs and immunosuppressants followed by anticoagulant drugs.CONCLUSION: DDW-J scale,which is more close to clinical diagnostic criteria,contributed to the standardization of the diagnostic criteria of DILD,yet it has its limitations as well.

Osteoporosis is a systemic metabolic osteopathy characterized by low bone mineral density, leading to an increased risk of bone fractures. The study on the treatment of osteoporosis is mostly a research hotspot, and traditional Chinese medicine in treatment of this disease has its distinctive ascendancy. A large quantity of research indicates that the effect of Longspur epimeium (LE) for treatment of osteoporosis is definite. In this article, the authors summarized the drug components, the results of experimental research and clinical trial of LE for treatment of osteoporosis in recent years.

Objective To investigate the effect of ifenprodil in the mice of bone cancer pain.Methods 96 male C3H/HeJ mice were divided randomly into tumor group( Group T),control group( Group C) and sham group( Group S).The α-minimal essence media(ct-MEM) with 2 × l05 osteosarcoma NCTC 2472 cells were implanted into the intramedullary space of the right femurs of mice to induce ongoing bone cancer related pain behaviors.The sham group was inoculated by α-MEM without any cells.On the 14th d after inoculation,pain ethology indexes such as the spontaneous lifting behaviors,the paw withdrawal mechanical threshold(PWMT) and the paw withdrawal thermal latency (PWTL)were observed on 1 d before inoculation and on 3 d,5 d,7 d,10 d,14 d,17 d,19 d,23 d after inoculation.Lumbar intumescentia of mice in each group were taken out to investigate the expression level of NR2B western blot after pain behaviors tests at the same time point after intrathecal injection.Results ( 1 ) At day14 after the operation,the obvious increasing of spontaneous lifting behaviors ( ( 12.88 ±1.64) ) and the expression of NR2B (2.12 ±0.13),the significant decreasing of PWMT( (0.39 ±0.17)g) and PWTL( ( 11.59 ± 1.67 ) s ) were observed in group T compared with group S and preoperative base level (P ＜ 0.05 ).(2) At day 17,day 19 and day 23 after the operation,compared with the basal level of dayl4 before administration and group C,the spontaneous lifting behaviors ( (5.13 ± 1.38),(4.70 ± 1.58),(5.64 ± 1.17) ) of group T were obviously decreased,PWMT ( ( 1.10 ± 0.65 ) g,( 0.95 ± 0.56 ) g,( 1.05 ± 0.26 ) g) and PWTL ( ( 15.17 ± 1.27) s,( 15.93 ± 2.18 ) s,( 16.28 ± 1.48 ) s ) were increased,the expression of NR2B ( ( 1.42 ± 0.17),(1.67 ±0.53),(1.14 ±0.79) ) were significantly decreased(P＜0.05).Conclusion Repeated intratheal injection of ifenprodil can efficiently relieve spontaneous lifting behaviors,mechanical hyperalgia and thermal hyperalgia and decrease the expression of lumbar intumescentia NR2B in the mouse model of bone cancer pain.