Objective To evaluate the effect for the treatment of severe asthma. Methods The data of 47 patients with severe asthma who were admitted to emergency department were retrospectively anayzed. Results Of total 47 patients ,45 were rescued, with the survival rate of 95.7%. Arterial blood gas was improved after treatment (P < 0.01). Conclusion Appropriate commencement, mode, strategy, and early weaning of mechanical ventilation, combined with the administration of bronchodilators and eorticosteroids are the important way to rescue patients with severe asthma.

BACKGROUND: There are various reports on studies of tear secretion and tear film function in patients with diabetes mellitus over the past. In recent years, tear proteins have drawn more and more attentions on evaluation of tear film function.OBJECTIVE: To observe the contents of main tear proteins and basal tear secretion of patients with type 2 diabetes mellitus and normal persons so as to probe into tear secretion and tear film function of patients with diabetes mellitus.DESIGN: Case-control observation was designed.SETTING: Department of Ophthalmology, Southwest Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: Totally 50 cases (100 eyes) of type 2 diabetes mellitus were employed, which were diagnosed in Department of Ophthalmology and Department of Endocrinology, Southwest Hospital of Third Military Medical University of Chinese PLA from December 2001 to December 2002. They were free from ocular surgical and laser treatment, local medication in recent period and contact lens. Of those, there were 25 cases (50 eyes) in proliferating diabetic retinopathy group and 25 cases (50 eyes) in nonproliferating diabetic retinopathy group. In addition, 25 cases (50 eyes) of normal persons with matched age and sex were taken as the control group.There was no significant difference in age and sex among 3 groups (x2=0.024,0.321 ;P ＞ 0.05). All of the participants were in the know before the experiment.METHODS: [1] Tear collection: 10 cases (20 eyes) were randomized from two diabetic groups and the control successively. Capillary pipette method was used to collect non-irritative tear 10 μL from lower lacrimal punctum that was preserved in refrigerator at -20 ℃ (＜ 1 month). [2] Determination of total tear protein amount: Lorry method was used to determine the concentration of total tear protein, in which, calf serum albumin was taken as the criteria. [3] Determination of contents of main tear proteins: SDS-PAGE (sod.dodecyl sulfate-polyacrylamide gel electrophoresis) was used and Coomassie brilliant blue staining and Bio-Rad imaging analyzing system were applied for the analysis of isolated protein strips in quality and quantity. [4] Determination of rupture time of tear film: glass rod was used to get 20 g/L fluorescein sodium and drop in conjunctival sac. The examined person was required to blink gently for several times and open the eyes naturally and stare forward. That the first ruptured "black hole" was discovered on the complete tear film was taken as the rupture time of tear film. [5] Experiment of basal tear secretion: No.41 Whatmann filtering paper was used, folded in 5 mm, and placed at 1/3 of conjunctiva in the lower eyelid. Five minutes later, the paper was removed and length of it after wetting was measured. [6]Experiment with rose Bengal staining: glass rod was used to get 10 g/L rose Bengal and drop in conjunctival sac. After eyes blinking for several minutes, the observation was performed with green light filter under slit lamp (evaluation criteria: corneal conjunctiva of palpebral fissure stained+, stained to the inferior bulbar conjunctiva++,stained to the superior bulbar conjunctiva). Dry eye disease was diagnosed indirectly with red-stained epithelial cells and mucin.MAIN OUTCOME MEASURES: [1] Concentration of total tear protein. [2]Concentrations of various main tear proteins. [3] Rupture time of tear film. [4]Value of basal tear secretion. [5] Positive rate of rose Bengal staining.RESULTS: Totally 50 cases (100 eyes) in diabetes groups and 25 cases(50 eyes) in the control group all entered result analysis. [1] Concentration of total tear protein: there was no significant difference among 3 groups (P＞ 0.05). [2] Concentrations of various main tear proteins: the results of lysozyme, lactoferritin and tear specific prealbumin in proliferating diabetic retinopathy group were lower remarkably compared with the control[ (0.94±0.21)vs ( 1.33±0.31 )g/L , ( 1.10±0.24)vs ( 1.67±0.43 )g/L, (0.98±0.22) vs (1.49±0.32)g/L, P ＜ 0.01]. Compared with non-proliferating diabetic retinopathy group, the results of lactoferritin and tear specific prealbumin were lower (P ＜ 0.05). There was no significant difference in human serum albumin among 3 groups (P ＞ 0.05). [3] Rupture time of tear film:compared with non-proliferating diabetic retinopathy group and the control, the rupture time of tear film in proliferating diabetic retinopathy group was reduced significantly [(7.68±2.21)s vs (9.92±2.37)s and(10.80±2.23)s,(P ＜ 0.01 )]. [4] Value of basal tear secretion: the value in proliferating diabetic retinopathy group was less significantly than that in non-proliferating diabetic retinopathy group and the control [ (8.00±2.10)vs( 11.02± 1.97 )mm and ( 12.17±2.08 )mm, P ＜ 0.05]. [5] Positive rate of rose Bengal staining: the positive rate in proliferating.diabetic retinopathy group was higher significantly than non-proliferating diabetic retinopathy group and the control (48% vs 24% and 14%, P ＜ 0.05, P ＜ 0.01).CONCLUSION: It is suggested in the results of this paper that abnormal tear secretion and tear film function are apt to present in patients with type 2 diabetes mellitus and the declined tear film function is more remarkably in the patients with proliferating diabetic retinopathy specially. SDS-PAGE benefits the discovery of changes in tear proteins in diabetic patients.

OBJECTIVE:To observe the clinical efficacy of entecavir combined with intervention in the treatment of liver cancer patients with HBV DNA-negative hepatitis B. METHODS:100 liver cancer patients with HBV DNA-negative hepatitis B were random-ly divided into observation group and control group,50 cases in each group. Control group received intervention,percutaneous punc-ture of femoral artery,then injected Pirarubicin hydrochloride for injection + lipiodol in parent artery until blood stagnation,and also conventional liver protection therapy was conducted;observation group additionally received 1 mg Entecavir tablet,qd,for continuous 6 months. Clinical efficacy,HBV DNA quantification,Child-Pugh score and liver function indexes in 2 groups were compared. RE-SULTS:The total effective rate in observation group was 44.0%,which was significantly higher than control group(26.0%),the dif-ference was statistically significant(P<0.05). There were no significant differences in HBV DNA quantification,Child-Pugh score and liver function indexes between 2 groups(P>0.05). After treatment,HBV DNA quantification,Child-Pugh score,fetoprotein,alanine aminotransferase, total bilirubin and aspartate aminotransferase significantly decreased in observation group,the differences were statis-tically significant compared with control group (P<0.05). CONCLUSIONS:Entecavir combined with intervention can obviously im-prove the clinical efficacy and liver function indexes of liver cancer patients with HBV DNA-negative hepatitis B.

Objective To evaluate the effect of hydrogen on the expression of nuclear factor E2?related factor 2 ( Nrf2 ) during endotoxin?induced oxidative injury to macrophages. Methods Normally cultured Raw264.7 cells were divided into 4 groups ( n=36 each) using a random number table: control group (group C), hydrogen?rich saline group ( group H), endotoxin group ( group E) and endotoxin plus hydrogen?rich saline group (group EH). In E and EH groups, endotoxin was added with the final concentration of 1 μg∕ml. Hydrogen?rich saline ( hydrogen concentration 0. 06 mmol∕L) was added in H and EH groups. All the cells were incubated for 48 h. At 6, 24 and 48 h of incubation, cells were collect?ed to detect the activity of reactive oxygen species ( ROS) , and cells were collected and proteins extracted for determination of superoxide dismutase ( SOD) and catalase ( CAT) activities and Nrf2 expression by Western blot. Results Compared with group C, the ROS activity was significantly increased, the levels of SOD and CAT were significantly decreased, and the expression of Nrf2 was significantly up?regulated in E and EH groups (P<0.05), and no significant change was found in the parameters mentioned above in group H (P>0.05). Compared with group E, the ROS activity was significantly decreased, the levels of SOD and CAT were significantly increased, and the expression of Nrf2 was significantly up?regulated in group EH (P<0.05). Conclusion Hydrogen can attenuate endotoxin?induced oxidative injury to macro?phages, and the mechanism may be related to up?regulated expression of Nrf2.

OBJECTIVE:To investigate the effect of different doses of oxaliplatin on the efficacy and safety and related index-es of patients with hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE). METHODS:100 HCC patients were randomly divided into control group (50 cases) and observation group (50 cases). After TACE,control group re-ceived arterial infusion chemotherapy of 40 mg/m2 oxaliplatin,once a day+20 mg Epirubicin hydrochloride for injection,once a day,with little lipiodol. Observation group received arterial infusion chemotherapy of 80 mg/m2 oxaliplatin (the same usage with control group)+Epirubicin hydrochloride for injection(the same dosage with control group),with little lipiodol. Alanine aminotrans-ferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBIL),white blood cell count (WBC) and alpha-fetoprotein (AFP) in 2 groups after 3 d treatment were observed,and the total overall survival (OS) and the incidence of adverse reactions were followed-up. RESULTS:Abdominal pain,incidences of nausea and vomiting,ALT,AST and TBIL in observation group were significantly higher than control group,WBC was significantly lower than control group,the differences were statistically sig-nificant (P<0.05). There were no significant differences in fever,hair loss,incidence of peripheral neurotoxicity,OS in 1 year and 3 years,and AFP in 2 groups(P>0.05). CONCLUSIONS:Compared with 40 mg/m2 oxaliplatin,80 mg/m2 can reduce the in-cidence of abdominal pain,nausea,vomiting,but other effects are poor than 40 mg/m2,and it can not prolong the survival time of patients.

AIM: To assess the changes of macular thickness of acquire immunodeficiency syndrome ( AIDS) patients.
METHODS:The study based on the data analysis of 38 human immunodeficiency virus ( HIV ) positive patients ( 64 eyes ) . According to CD4 count and whether cytomegalovirus retinitis ( CMVR) happened, the patients were divided into 3 groups. Group A included 16 patients (32 eyes), in which CD4 count was < 50cells/μL and CMVR did not happen. Group B included 10 patients ( 20 eyes), in which CD4 count was>50cells/μL and CMVR did not happen. Group C included 12 patients (12 eyes), in which CD4 count was < 50cells/μL and CMVR just happened. Group D included 10 healthy people ( 20 eyes ) , as normal control group. By using optical coherence tomography ( OCT ) , thickness of retina along with a 1mm diameter circle centered on macular was evaluated.
RESULTS:The mean foveal thicknesses in groups A, B, C and D were 254. 03±15. 63μm, 263. 11±17. 12μm, 304. 50±50. 62μm and 257. 64±8. 54μm in order. Compared with foveal thickness in each group, there were significant differences in general (F=12. 933, P=0. 000). The mean foveal thickness in groups CMVR increased, which was of significant difference (P= 0. 000), compared with other groups.
CONCLUSION: CMVR can impair the structure and function of macular, which then seriously affects the visual function of patients. It's helpful to understand the progress and prognosis of CMVR disease by observing macular structure with OCT in early time.

Objective To investigate the factors influencing basic rehabilitation service needs of people with disability at Zhabei District in Shanghai .Methods Primary rehabilitation demands and services of 10 311 disabled persons in Zhabei District were surveyed.Results The screening rate of persons with disability having primary rehabilitation demands was 83.5%. And the gender, age, type of disability, disability level, education, employment might be the factors affecting the primary rehabilitation demands of people with disability.Conclusion The primary rehabilitation service demands vary in deferent types of people with disability. The various services based on the extensive rehabilitation services should be provided to deferent categories of people with disability.

Objective To understand the status of special rehabilitation service demands of people with disability at Zhabei District in Shanghai and to provide the basis for the policy development.Methods Screen rate (SR) was used to indicate the level of demand of rehabilitation service, the data were analyzed with SPSS 13.0 statistical software.Results There were 4 349 persons with disability who demanded the special rehabilitation service; the SR of “on-site rehabilitation service” demands was the highest among the whole persons with disability; the SR of “personalized allotment of supplies and appliances” demands of the intellectual disability and mental disability was lower than the other types; the SR of special rehabilitation service demands of the female, the elderly, the low cultural level, the unemployed and the people with severe disability were relatively higher.Conclusion The form of “on-site rehabilitation services” needs to improve based on the demand of the disabilities; “personalized supplies and appliances” for the intellectual disability and mental disability needs to further develop; the rehabilitation services targeted to the female, the elderly, the low cultural level, the unemployed and the people with severe disability need to improve.

Objective To provide the advice on how to optimize the allocation of resources and make other policy through the analysis factors affecting rehabilitation services needs of people with disability at Zhabei district in Shanghai.Methods The factors affecting rehabilitation services needs such as types of disability, disability levels, education, employment, marital status, age and sex were analyzed with Logistic analysis.Results The factors affecting primary rehabilitation services were types of disability, education, employment situation, marital status and sex. And people with disability had the characters of female, hearing disability, retired returned to more primary rehabilitation services, with OR values being 1.219, 1.544 and 1.533 respectively compared with itself controls. And the high educational disable people' will, returning to primary rehabilitation services, was weaker compared with low educational disable people. The factors affecting special rehabilitation services were types of disability and employment situation. And people with disability had the characters of hearing disability, unemployment returned to more special rehabilitation services, with OR values being 2.380 and 1.310 respectively compared with itself controls.Conclusion The rehabilitation needs are different among different groups people with disability, so the factors affecting rehabilitation services needs such as types of disability, education, employment situation, marital status and sex should be taken into consideration while activating primary rehabilitation services, while the types of disability and employment situation should be taken into more consideration while activating special rehabilitation services.

Abstract： Objective　To investigate the distribution and antimicrobial resistance profile of the bacterial strains isolated from blood cultures in neonatal septicemia children of Neonatology Department, the First People's Hospital of Chuzhou during Jan. 2017-Dec. 2021, in order to guide clinical rational drug use. Methods　The distribution and the results of antimicrobial susceptibility tests and characteristics of the pathogenic bacteria isolated from blood culture samples in neonatal septicemia children in the First Hospital of Chuzhou from Jan. 2017 to Dec. 2021 were retrospectively analyzed. The results were analyzed with WHONET 5.6 software, according to the Clinical and Laboratory Standards Institute (CLSI) 2021 breakpoints. 　Results　A total of 189 strains were isolated from the 4 538 sample of blood cultures, the positive rate was 4.2%, including 59(31.2%) Gram-negative bacterial strains, 130 (68.8%) Gram-positive bacterial strains. The most frequently isolates were coagulase-negative staphylococci（64.0%), Serratia liquefaciens (15.9%), Escherichia coli (3.2%), Acinetobacter lwoffii (2.6%) and Delftia acidovorans (2.6%). The prevalence of methicillin-resistant isolates was 81.8%(99/121) in coagulase-negative Staphylococci and 25.0%（1/4） in Staphylococcus aureus. No staphylococcal strains were found resistant to vancomycin, quinupristin-dalfopristin or linezolid. The sensitivity of the antibacterial drug monitored by Serratia liquefaciens was 100.0%.Conclusions　Gram-positive bacterial are the main pathogen of neonatal septicemia, and is highly resistant to the common antibacterial drugs. The clinical should choose antibacterial agents reasonably according to drug sensitivity.