ObjectiveTo compare the different efficacy between invasive positive pressure ventilation andnoninvasivepositivepressureventilationofacuteexacerbationchronicobstructivepulmonary disease.Methods Patients with acute exacerbation chronic obstructive pulmonary disease were randomly divided into invasive positive pressure mechanical ventilation ( IPPV ) group ( n =35 ) and noninvasive positive pressure mechanical ventilation (NPPV)group (n =37 ),and clinical data before and after treatment were analyzed retrospectively.ResultsAfter 2 hours of invasive positive pressure mechanical ventilation,pH,arterial oxygen partial pressure( PaO2 ),arterial carbon dioxide partial pressure ( PaCO2 ),heart rate ( HR ),respiratory rate(RR),Glasgow coma scale(GCS) score were better than those before treatment[ pH:(7.35 ± 0.05)vs ( 7.23 ± 0.02 ) ; PaO2:( 92.4 ± 14.5 ) mm Hg vs ( 51.3 ± 9.4 ) mm Hg; PaCO2:( 56.0 ± 7.7 ) mm Hg vs( 82.6 ±8.1)mm Hg;GCS:(10.5 ± 1.1)points vs(8.5 ± 1.2)points;HR:(110 ± 12) times/min vs(131 ± 19) times/min ; RR:( 26 ± 4) times/min vs ( 35 ± 8 ) times/min ; P ＜ 0.05 or P ＜ 0.01 ].But in NPPV group,only the PaO2,HR,RR were better than those before treatment [ PaO2:( 78.6 ± 8.8 )mm Hg vs ( 53.1 ± 8.9 ) mm Hg; HR:( 110 ± 24) times/min vs ( 128 ± 23 ) times/min ; RR:( 26 ± 5 ) times/min vs ( 36 ± 9 ) times/min; P ＜ 0.05 ].And after 6 hours,pH,PaCO2,GCS score were significantly better in NPPV group [ pH:( 7.35 ± 0.03 ) vs ( 7.25 ±0.01 ) ;PaCO2:(59.0 ±6.3) mm Hg vs(79.8 ±7.0) mm Hg;GCS:( 10.6 ± 2.0) points vs( 8.5 ±2.5) points;P ＜ 0.05 or P ＜ 0.01 ].There was no difference on the days in ICU [ ( 15 ± 4) d vs ( 14 ± 4 ) d,t =1.102,P ＞0.05 ],the duration of mechanical ventilation[ ( 168 ± 25 )d vs( 170 ± 23 )d,t =1.214,P ＞ 0.05 ],the mortality in ICU (22.8％ (8/28) vs 21.6％ (8/37),x2 =0.016,P ＞ 0.05) between IPPV group and NPPV group.ConclusionIPPV can improve the situation of AECOPD quickly,but in NPPV group some patients need intubation.However,there was no significant difference on the days in ICU,the duration of mechanical ventilation,the mortality in ICU between IPPV and NPPV.

Objective To explore the relationship between the polymorphism of integrin-metalloproteinase-33 (ADAM33) gene and bronchial asthma. Methods Subjects were selected from the Department of Respiratory Medicine in our department from June 2015 to December 2016 in the treatment of 120 cases of asthma patients as the observation group, the same period into our hospital physical examination of 120 healthy children as the control group. The patients were enrolled in the upper extremity elbow vein and extracted DNA, followed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequencing. The frequency of T2 genotype distribution and the frequency distribution of T2 locus and the relative risk of asthma were compared according to Hardy-Weinberg equilibrium law. Results The frequency of A gene in the T2 allele of the subject was significantly higher than that of the control group. The frequency of A gene in the T2 allele was significantly higher than that in the control group (P<0.05) There was significant difference between the two groups (χ2=8.09, P=0.00), and the increase of A allele was the risk factor of asthma (OR=2.32); the observation group T2 gene AG (χ2=4.21, P=0.04), and the increase of AG allele was the risk factor of asthma. The frequency of asthma was significantly higher than that of control group (OR=1.89). Conclusion ADAM33 gene T2 locus polymorphism is significantly associated with bronchial asthma, which can significantly increase the risk of bronchial asthma.

BACKGROUND:Previous studies have confirmed that as an exogenous origin of endometrial epithelial cel s, bone marrow stem cel s are involved in the functional reconstruction of the injured endometrium. OBJECTIVE:To discuss whether bone marrow mesenchymal stem cel s can differentiate into endometrial epithelial cel s in vitro. METHODS:Passage 2 bone marrow mesenchymal stem cel s and endometrial stromal cel s were col ected and subjected to different treatments:bone marrow mesenchymal stem cel s were cultured alone in the DMEM/F12 medium containing 2%fetal bovine serum or in the DMEM/F12 medium containing 2%fetal bovine serum, 10-7 mol/Lβ-estradiol and 10μg/L epidermal growth factor as groups 1 and 2, respectively;bone marrow mesenchymal stem cel s co-cultured with endometrial stromal cel s by Transwel chamber were cultured in the DMEM/F12 medium containing 2%fetal bovine serum or in the DMEM/F12 medium containing 2%fetal bovine serum, 10-7 mol/Lβ-estradiol and 10μg/L epidermal growth factor as groups 3 and 4, respectively. After 5 days culture, bone marrow mesenchymal stem cel s at the bottom of the culture plate were col ected to detect expressions of epithelial cel markers, such as CK7, CK18, CK1 and EMA by RT-PCR technology, and to determine keratin expression using immunofluorescence assay. Besides, expressions of these epithelial cel markers in the group 3 were detected using RT-PCR at 1, 3, 5 and 7 days of culture, respectively. RESULTS AND CONCLUSION:mRNA expression of CK7 showed a significant successive rise in the groups 1, 2, 3, 4 and it was highest in the group 4. mRNA expressions of CK18 and CKl9 in the later three groups had no significant differences, but al significantly higher than those in the group 1. Compared with the groups 1 and 3, mRNA expression of EMA in the groups 2, 4 were significantly higher, but no significant differences existed between groups. Expression of keratin was strongly positive in the group 4, weakly positive in the group 3 and negative in the groups 1, 2, respectively. Furthermore, with the increase of culture time, mRNA expression of CK7 exhibited a constant increase, which was significantly higher at 5 and 7 days than at 1 and 3 days;but there were no significant differences in expressions of CKl9, CKl8 and EMA at different time points. These results show that bone marrow mesenchymal stem cel s can differentiate into endometrial epithelial cel s in vitro under certain conditions. Moreover, it can remarkably promote the endometrial differentiation under the combined effects of some exogenous and endogenous factors.

Objective To investigate the clinical characteristics and prognosis of acute myocardial infarction (AMI) combined with ventrical septal perforation (VSP).Methods Fifty-seven AMI + VSP patients were retrospectively analyzed their clinical characteristics and outcomes who were treated in the Fourth People' s Hospital of Shenyang and the First Hospital Affiliated to China Medical University from June 2000 to May 2014.Results Of all patients,43 (75.4％) VSP occurred anterior wall AMI,and 14 (24.6％) were not.Echocardiogram show the end diastolic diameter of left ventricle was (53.7 ± 9.5) mm,left ventricle ejection fraction was (48.5 ± 11.8)％,VSP diameter was (9.8 ±7.9) mm,and 37(64.9％) were with near apex.The level of cardiactroponin I,C-reactive protein,and N terminal of B type natriuretic peptide of patients were (16.7 ± 12.9) μg/L,(99.7 ± 31.40 mg/L,(3 051.2 ± 879.7) μg/L.Total mortality was 71.9％ (41/57) in 30 days and 78.9％ (45/57) in 1 year.The mortality of operation group was 73.9％ (17/23) in 30 days and 91.3％ (21/23) in 1 year.The mortality of consecutive therapy was 64.7％ (22/34) in 30 days and 76.5％ (26/34) in 1 year.Conclusion The mortality of AMI + VSP is higher and operation is the most effective therapeutic method.

Objective To determine the pathological mechanism of gastrolithiasis formation in vitro and the effects of pectinase on gastrolithiasis. Methods The test in vitro was divided randomly into two groups:(1) Haws and persimmons(25g respectively) were chewed and put into two clean containers filled with fresh gastric juice.(2) Wine containing 30% alcohol(50ml) was added to the container. Each group included 4 collections.All two groups were placed in 37℃ calorstat box to observe the course and time of gastrolith formation. After gastrolith formation, 2g pectinase was added to the container and observed the decomposition of pectinase to gastrolith and the time was recorded. The effects of pectinase on 54 patients with gastrolithiasis were also investigated. Results The mean time of haws juice coagulation and persimmons was 23 minutes and 25 minutes respectively in the group without wine; but in the group with wine, the mean time of haws juice coagulation and persimmons was 14 minutes and 19 minutes respectively. After adding pectinase, the mean time of clot initiated decomposition was about 17 minutes in both groups, but complete decomposition needed 34 minutes. All the 54 patients with gastrolithiasis who received pectinase were cured.The gastrolith disappeared 6 hours after taking pectinase confirmed by barium meal examination. Conclusions Haws and/or persimmons mixed with gastric juice could induce gastrolith formation. The effects of pectinase on patients with haws or persimmons gastrolithiasis are good, this therapeutic procedure is simple, and the gastrolith resolves quickly.Pectinase may be widely used in the treatment of gastrolithiasis.

After the culture in college and university medical library was described, the necessity of its construc-tion was elaborated, and its implementation measures were stressed, such as setting up experience area, bringing into play of Primal interactive 3D anatomical database, planning subject activities according to the health holidays, providing personal space for users based on library websites, effectively popularizing reading, consecutively expan-ding service space, and carrying out personal service.

Objective To investigate a practical scientific method for measurement of thyroid remnant in endoscopic thyroidectomy via breast approach.Methods The clinical data of 95 hyperthyroid patients were reviewed and analyzed.The patients were submitted to endoscopic thyroidectomy via breast approach and bilateral subtotal thyroid resection were performed.Thyroid remnant were assessed by naked eyes in 32 cases,thyroid remnant measuring tape in 63 cases.The therapeutic effect was observed.Results All the operations were successfully performed.There was no dyspnea,bleeding,recurrent laryngeal nerve and thyroid gland injury,postoperative recovery was well.The function of thyroid gland was reviewed after operation every 2-3 months,and reviewed by color ultrasound after operation every 6 months.Followed up for 1.8-6.0 years.In 32 patients whose thyroid remnant were assessed by naked eyes,3 patients showed relapse after operation 3 months,2 patients developed hypothyroidism.In 63 patients whose thyroid remnant were assessed by thyroid remnant measuring tape,there had no relapse and hypothyroidism.Conclusion Using thyroid remnant measuring tape in endoscopic thyroidectomy,according to 3.0,2.0,0.5 measurement method,make 1.06 g/cm3 as standard,is scientific,practical and clinical feasible.

Adult ; Female ; Gastritis ; therapy ; Humans ; Male ; Massage ; Middle Aged

PDCA cycle was applied in special rectification activities for medical instrument clinical trial, with quality criteria of implementation made. Completed medical instrument clinical trial from January 2011 to December 2012 was believed as control group, from January 2013 to December 2014 as PDCA group, the scores of clinical trial and the score rate of items were compared and analyzed. Results show quality scores of clinical trial in PDCA group are higher than that in control group (51 vs. 81, P < 0.001), score rate of items increased except adverse events (P < 0.001). The special rectification activities with PDCA applied in our department are feasible and effective. It significantly improves implement quality of medical instrument clinical trial.
Clinical Trials as Topic ; Equipment and Supplies ; standards ; Humans ; Research Design

PDCA cycle was applied in special rectification activities for medical instrument clinical trial, with quality criteria of implementation made. Completed medical instrument clinical trial from January 2011 to December 2012 was believed as control group, from January 2013 to December 2014 as PDCA group, the scores of clinical trial and the score rate of items were compared and analyzed. Results show quality scores of clinical trial in PDCA group are higher than that in control group (51 vs. 81, P < 0.001), score rate of items increased except adverse events (P < 0.001). The special rectification activities with PDCA applied in our department are feasible and effective. It significantly improves implement quality of medical instrument clinical trial.
Clinical Trials as Topic ; standards ; Equipment and Supplies ; standards ; Humans ; Research Design ; standards