Objective To investigate the prevalent condition of endotracheal cuff pressure and risk factors for under inflation. Methods A prospective cohort study was conducted. Patients admitted to the Department of Critical Care Medicine of Fuxing Hospital Affiliated to Capital Medical University,who were intubated with a high-volume low-pressure endotracheal tube,and had undergone mechanical ventilation for at least 48 hours,were enrolled. The endotracheal cuff pressure was determined every 8 hours by a manual manometer connected to the distal edge of the valve cuff at 07:00,15:00,and 23:00. Measurement of the endotracheal cuff pressure was continued until the extubation of endotracheal or tracheostomy tube,or death of the patient. According to the incidence of under inflation of endotracheal cuff,patients were divided into the incidence of under inflation lower than 25%group(lower low cuff pressure group)and higher than 25% group(higher low cuff pressure group). The possible influencing factors were evaluated in the two groups,including body mass index(BMI),size of endotracheal tube,duration of intubation,use of sedative or analgesic,number of leaving from intensive care unit(ICU),the number of turning over the patients, and aspiration of sputum. Logistic regression analysis was used to determine risk factors for under-inflation of the endotracheal cuff. Results During the study period,53 patients were enrolled. There were 812 measurements,and 46.3%of them was abnormal,and 204 times(25.1%)of under inflation of endotracheal cuff were found. There were 24 patients(45.3%)in whom the incidence of under inflation rate was higher than 25%. The average of under inflation was 7(4,10)times. Compared with the group with lower rate of low cuff pressure,a longer time for intubation was found in group with higher rate of low cuff pressure〔hours:162(113,225)vs. 118(97,168),Z=-2.034,P=0.042〕. There were no differences between the two groups in other factors,including size of endotracheal tube,the time from intubation to first measurement of endotracheal cuff pressure,number of leaving from ICU during admission, use of sedative agent or analgesic,and the number of body turning and aspiration(all P>0.05). No risk factor was found resulting from under inflation of the endotracheal cuff by logistic regression analysis. No significant difference was found in the incidence of ventilator associated pneumonia,duration of mechanical ventilation,successful rate of weaning on 28th day,or 28-day mortality after weaning from mechanical ventilation,and ICU mortality between the two groups. However,patients in the group of higher rate of low cuff pressure had a longer ICU stay compared with that in the group of lower rate of low cuff pressure group〔days:13(8,21)vs. 10(6,18),Z=-2.120,P=0.034〕. Conclusions Abnormal endotracheal cuff pressure is common in critically ill patients with intratracheal intubation. Duration of intubation is associated with under inflation of the cuff,and it calls for strengthening monitoring and management.

Humans ; Integrative Medicine ; Sleep Wake Disorders ; therapy

The PIWI family members are defined as conserved PAZ and PIWI domains and play important roles in stem-cell self-renewal,spermatogenesis,RNA interference and translational regulation.Recent researches have showen that some PIWI are specifically expressed in tumors and associated with tumor development and growth.PIWI is likely to be a new significante index for tumor diagnose and prognosis,the feasibility of PIWI acting in tumor gene theropy could be in vestigated by studying the mechanism of PIWI expression and regulation.

Endothelial progenitor cells(EPC),which have the capacity to differentiate into mature endothelial cells,have been found to home to and incorporate into the angiogenic vasculature of growing tumors with high specificity once mobilized into the circulation.Yet the mechanism still remains unclear.EPC have potential as spatial-specific delivery vehicles.Thus,further studies on the mechanisms of tumor neovascularization and tumor therapy in glioma using genetically engineered EPC as angiogenesis-selective vectors will be of help to explore the potential in the basic and clinical application of EPC in(glioma.)

Apelin is a polypeptide consisting of 77 amino acids. Apelin receptors are found to be the angiotensin-like G protein coupled receptor (APJ). Apelin/APJ system is widely distributed in the peripheral and central nervous system. Apelin-13 is one of the subtypes of Apelin, which has strong biological activity. This study reviewed the new research prog?ress of Apelin-13 on physiological and pathological processes involved in the cardiovascular system, respiratory system, ner?vous system, digestive system and endocrine system.

Objective To search the specific biomarkers in serum of patients with silicosis for early diagnosis. Methods Surface enhanced laser desorption ionization-time of flight-mass spectrometry (SELDI-TOF-MS) was used to search the specific biomarkers in serum samples from 60 silica-exposed workers (20 with no silicosis served as 0 group, 20 with suspected silicosis as 0+ group and 20 with stage I silicosis as stage I group), and 20 healthy men with no silica exposure as control. Serum samples were analyzed using the new generation of weak cationic exchange chip (CM10, Ciphergen Biosystems, America) and the protein fingerprint automatically collected using ProteinChip Biology System (PBSII-C) instrumentation. The data were analyzed by Ciphergen ProteinChip and BioMarker Wizard software. Results Compared with control group, ten biomarkers were differentially expressed among all the silica-exposed workers (P

Objective To investigate effect of Salvia miltiorrhiza Ligustrazine on peripheral lymphocyte neutrophil proportion, neurological function score and prognosis in patients with acute cerebral infarction. Methods 125 cases of acute cerebral infarction in our hospital from June 2015 to June 2016 were selected as the research object, randomly divided into two groups, the control group was treated with conventional treatment of acute cerebral infarction, patients in the observation group in the control group patients on the basis of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection, all patients were detected in the blood leukocyte classification, and the NIHSS evaluation of patients with neurological function and prognosis of the two groups of patients. Results After treatment, the observation group of white blood cells in patients with (×109/L), neutrophil (%), neutrophil / lymphocyte was significantly lower than the control group patients, two groups of patients before treatment, after treatment of 1 day and 7 days, two groups of NIHSS score comparison showed no significant difference, after the treatment of 14d patients in the observation group the NIHSS score was (11.1±3.3), which was obviously lower than the control group, the patients in the observation group were six cases death and disability in three cases, 53 cases of independent life, significantly better than the control group, the difference was statistical significance(P<0.05). Conclusion Salvia miltiorrhiza Ligustrazine can help to reduce the ratio of neutrophil / lymphocyte, improve neurological function and improve the prognosis of patients with acute cerebral infarction, and it is worthy of clinical application.

It is now widely accepted that platelet aggregation plays an important role in physiological hemostasis and pathological thrombosis associated with cardiovascular and cerebrovascular diseases. Anti-platelet aggregation drug research is also a hot spot of current research. The biggest challenge of antiplatelet therapy has been the molecular overlap of the hemostasis and thrombosis, leading to a serious risk of bleeding. Recent studies have emphasized the importance of shear stress generated from blood flow, which will primarily drive platelet activation and aggregation in thrombosis. So if we can take advantage of the differences between the physiological and pathological vascular blood flow environment, the development of selective anti-platelet therapy may be a safer treatment for cardiovascular and cerebrovascular diseases. In this review, we discuss the underlying mechanisms of shear-induced platelet activation. Later, we summarize the effects and mechanisms of compounds and traditional Chinese medicine on shear-induced platelet activation. The aim is to provide a reference for the study of biological pharmacology of traditional Chinese medicine for promoting blood circulation and removing blood stasis.

Objective To evaluate the effect of Danshen Chuanxiongqin injection combined with Xuesaitong capsule on blood viscosity in patients with pulmonary heart disease.Methods 80 patients with pulmonary heart disease who were admitted to our hospital between January 2013 and November 2015 were studied,the patients were randomly divided into the combined group and the control group according to the order of admission,40 cases in each group.Control groups were treated with Xuesaitong capsule,and the combined group were treated with Danshen Chuanxiongqin injection on the basis of the control group.The clinical efficacy,blood viscosity(whole blood viscosity,plasma viscosity,whole blood viscosity ratio),blood indexes(blood platelet aggregation rate,erythrocyte aggregation index,erythrocyte deformation index),cardiac function and safety were observed.Results There were no significant differences in blood rheological indexes,LVEF,MAP and HR between the two groups before treatment.After treatment,the whole blood viscosity,plasma viscosity,whole blood viscosity ratio,platelet aggregation rate,erythrocyte aggregation index,erythrocyte deformation index,MAP and HR in the two groups were significantly lower than those before treatment,while LVEF was significantly higher,and the changes in the combined group were more significant than those in the control group(P<0.05).After treatment,the clinical total effective rate of treatment in the combined group(88.89％)was significantly higher than that in the control group(62.50％).Conclusion Danshen Chuanxiongqin injection combined with Xuesaitong capsule is effective in the treatment of pulmonary heart disease.It can significantly reduce blood viscosity,blood related indexes and improve cardiac function.

Identification and validation of a new target is one of the most important steps for new antituberculosis (TB) drug discovery. Researches have shown that Mycobacterium tuberculosis (Mtb) encodes 20 CYP450 enzymes which play important roles in the synthesis and metabolism of lipid, cholesterol utilization, and the electron transport of respiratory chain in Mtb. With the critical roles within the organism as well as the protein structures of six Mtb CYP450 enzymes being clarified, some of them have been highlighted as potential anti-tuberculosis targets. In this paper, the phylogenetic analysis, the structural features, and the enzymatic functions of Mtb CYPs, as well as the mechanism of interactions with selective inhibitors such as azole antifungal agents for the CYPs have been reviewed and summarized. The druggability of the CYPs has also been analyzed for their further utility as targets in high throughput screening and rational design of more selective inhibitors.
Antitubercular Agents ; chemistry ; pharmacology ; Azoles ; chemistry ; pharmacology ; Cytochrome P-450 Enzyme Inhibitors ; chemistry ; pharmacology ; Cytochrome P-450 Enzyme System ; genetics ; metabolism ; Drug Delivery Systems ; methods ; Drug Discovery ; Humans ; Mycobacterium tuberculosis ; drug effects ; enzymology ; genetics ; Phylogeny ; Tuberculosis ; drug therapy ; microbiology