Objective To understand the incidence.mortality and risk factors of ventilator -associated pneu-monia(VAP)in surgical intensive care unit among elderly patient,in order to direct the clinical prevention and treat-ment of VAP.Methods Retrospective analysis was used on 65 cases of mechanical ventilation elderly patients in our hospital nearly 3 years.Results The incidence of VAP was 66.2%.The mortality of VAP was 67.4%.The factors of long-term mechanical ventilation,high APACHE Ⅱ score,low Glasgow score and inappropriate initial antimicrobial therapy were influenced the prognosis of VAP.Conclusion The incidence of VAP can be decreased and the cure rate can be increased by some effective measures in SICU.

Adult ; Female ; Humans ; Male ; Occupational Diseases ; Organometallic Compounds ; poisoning

Humans ; Organometallic Compounds ; chemistry ; metabolism ; toxicity

Adult ; Anesthesia, General ; Bronchoalveolar Lavage ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; surgery ; Ventilators, Mechanical

Adult ; Bronchoalveolar Lavage ; adverse effects ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Tachycardia, Sinus ; etiology

Objective: To investigate the preventive effect of total flavonoids from Nymphaea candida (NCTF) on carbon tetrachloride (CCl4)-induced hepatic fibrosis in rats. Methods: Wistar rats were randomly divided into control group, model group, NCTF groups (50, 100, 200 mg/kg) and colchicine group (0.2 mg/kg). Rats were subcutaneously injected with 50% CCl4 peanut oil solution (0.1 mL/100g, twice a week for 12 weeks) to induce hepatic fibrosis. In addition to control and model group given with 0.5% CMC-Na, the other groups were intragastrically administered with drugs (1.0 mL/100 g, once a day for 12 weeks), all rats were put to death. Blood, hepatic and splenic tissue were collected to detect liver indexes. Pathological histology observation by Masson and HE staining were performed for other hepatic tissues. The expression of α-smooth muscle actin (α-SMA) in hepatic tissue was analyzed by immunohistochemical technique. The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total protein (TP) and albumin (ALB), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH) and nitric oxide (NO) were determined by automatic biochemical analyzer. The levels of serum laminin (LN), type III procollagen (PCIII), type IV collagen (CIV), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were measured by enzyme-linked immunoassay assay (ELISA). Serum hyaluronic acid (HA) was detected by radioimmunoassay. Hepatic tissue hydroxyproline (Hyp) was measured by spectrophotometric method. Result Compared with the control group, the rats showed energielos, liver and spleen index of those were increased, as well as inflammatory cell infiltration and obvious fibrosis of hepatic tissue were appeared in the model group; The levels of ALT, AST, ALP, HA, LN, PCIII, CIV, MDA, NO, TNF-α, IL-1β and IL-6 in serum in model group were increased significantly (P < 0.05, 0.01); The levels of TP, ALB, GSH and SOD in serum were decreased significantly (P < 0.01); The expressions of α-SMA and Hyp in hepatic tissue were significantly improved (P < 0.01). Compared with the model group, the levels of ALT, AST, ALP, MDA, NO in serum in NCTF group were significantly reduced (P < 0.05, 0.01); The levels of HA, LN, PC III, CIV, TNF-α, IL-1β and IL-6 were significantly reduced (P < 0.05, 0.01); The levels of TP, ALB, GSH and SOD were significantly increased (P < 0.05, 0.01); The expressions of α-SMA and Hyp in hepatic tissue were significantly reduced (P < 0.05, 0.01). Compared with the model group, the pathological damage of hepatic tissue was significantly improved, the degeneration and necrosis of liver cells in rat were significantly reduced (P < 0.05). Conclusion: NCTF has a better anti-hepatic fibrosis effect, its mechanism is related to antioxidant, regulation of collagen synthesis and inhibition of the proinflammatory factors expression.

To evaluate the clinical efficacy and safety of Qinghouyan lozenge in the treatment of acute pharyngitis due to Lung-heat and Yin-deficiency, and compare with Qinghouyan oral Liquid. Totally 144 subjects were enrolled and randomly divided into two groups (72 in the test group and 72 in the control group). The participants in the test group were given Qinghouyan lozenge for 5 days, and those in the control group were given Qinghouyan oral Liquid for 5 days. The effectiveness evaluation indexes were pharyngalgia/odynophagia disappearance rate, overall efficacy of TCM syndromes, TCM syndrome scores, and single syndrome and sign disappearance rate. During the test, the safety was evaluated by vital sign, lab examination indexes and adverse events. The results for the full analysis set showed that the couth disappearance rate, the incidence rate of TCM syndromes, and the throat/uvula congestion disappearance rate of the test group were higher than that of the control group (P < 0.05), with significant differences in the changes in syndrome scores between the two groups (P < 0.05). Altogether 3 adverse events were observed in the test group while 6 adverse events in the control group, without significant differences in the adverse event rate between the two groups (P < 0.05), serious abnormal laboratory examinations and vital signs. In conclusion, Qinghouyan lozenge has better efficacy in treatment of acute pharyngitis due to Lung-heat and Yin-deficiency than Qinghouyan oral liquid, with good safety.
Acute Disease ; Double-Blind Method ; Humans ; Medicine, Chinese Traditional ; Pharyngitis ; drug therapy

Objective To study the predictive value for adverse cardiac events (ACE) of left ventricular diastolic function measured by G-MPI. Methods Patients assessed by 2 days rest-stressed G-MPI during March 2012 to May 2013 in Beijing Hospital were collected and observed for the cumulative survival rate without ACE after G-MPI. ACE included cardiac death, non-fatal MI and late revascularization (60 d after the examination). Using quantitative gated SPECT (QGS) to get the LVEF and left ventricular peak filling rate (PFR). Using 17 segments, 5-point scoring system to get the summed stress score (SSS). Cox regression analysis was used to identify the independent predictors for ACE, and Kaplan-Meier method was used to investigate the cumulative survival rate without ACE.χ2 test was also used. Results A total of 11 patients who underwent early revascularization (within 60 d after G-MPI) were excluded and 139 patients (76 males, 63 females; average age 68.73 years) were assigned to different groups for outcome analysis, and 9 (6.5%, 9/139) patients had ACE in the whole group. Cox regression analysis showed that SSS, LVEF, PFR were the independent predictors for ACE (all P<0.05). Patients with PFR<2.1 EDV/s had a higher incidence of ACE than those with PFR≥2.1 EDV/s (14.3%(7/49) vs 2.2%(2/90), χ2=7.63, P<0.05). Kaplan-Meier survival analysis showed that the cumulative survival rate without ACE was lower in patients with PFR<2.1 EDV/s than that in patients with PFR≥2.1 EDV/s (67.7% vs 95.0%), and lower in patients with LVEF<50% than that in patients with LVEF≥50%(32.0% vs 90.8%), and also lower in patients with SSS≥8 than those with SSS<8(62.0% vs 94.7%; χ2 values: 11.92,11.27, 10.40, all P<0.01).Combining PFR with SSS and LVEF respectively, Kaplan-Meier survival analysis showed that the cumulative survival rate without ACE in patients with LVEF≥50% was higher than that in patients with LVEF<50% when PFR<2.1 EDV/s (76.7% vs 30.8%), and also higher in patients with SSS<8 than that in patients with SSS≥8 when PFR≥2.1 EDV/s (100% vs 72.2%; χ2 values: 7.14, 13.09, both P<0.01). Conclusion PFR of left ventricular diastolic function measured by G-MPI is one of the independent predictors for ACE, and it could effectively improve the predictive value for ACE if combined with LVEF and SSS.

Objective To investigate the influence of long non-coding RNA HOTAIR in proliferation and apoptosis of human tongue squamous cell carcinoma in vitro and in vivo. Methods siHOTAIR was used to inhibit the HOTAIR expression in Tb3.1 human tongue squamous cell carcinoma cell line. The experiments were divided into siHOTAIR group, nonsense sequence group and blank control group. Real-time PCR was used to detect the HOTAIR expression. MTT assay was employed to determine the cell survival. The expression levels of Bcl2, BAX, caspase-3, cleaved caspase-3 were examined by Western blot assay. Tb3.1 xenograft tumor model was established in BALB/c nude mice, and the tumor model was divided into control group, negative group, and siHOTAIR treated group. The tumor tissues were measured by immunohistochemistry stain (IHC) and TUNEL assay. Results The detection of real-time PCR showed that HOTAIR expression was reduced after treated with siHOTAIR. Western blots assay showed that Bcl-2 protein was suppressed while cleaved caspase-3 and BAX protein were up-regulated after treated with siHOTAIR. MTT assay indicated that the cell survival rate was significantly reduced in siHOTAIR treated group. Flow cytometry detected that apoptosis levels were increased in siHOTAIR group. The level of cell senescence was higher in the siHOTAIR group than that of control group. Results of IHC indicated that Ki-67 and Bcl-2 protein of tumor tissue were inhibited, while BAX and cleaved caspase-3protein expressions were elevated simultaneously in the siHOTAIR group. TUNEL assay suggested that more apoptosis was observed in siHOTAIR group. Conclusion HOTAIR can affect proliferation and apoptosis of tongue squamous cancer cells. HOTAIR may be one of the new candidate targets for human tongue cancer therapy.

Objective To study the expressions of HSP70 and AQP4 in the H.Pylori-associated gastritis mice of Pi-Wei hygropyrexia syndrome;To investigate the mechanism of Mieyou Soup. Methods The mice were randomly divided into high concentration of Mieyou Soup group, low concentration of Mieyou Soup group, gastric triad group, model group and control group. BALB/c mice of H.Pylori-associated gastritis mice of Pi-Wei hygropyrexia syndrome model was established by composite factor. After modeling, the mice were administered for of continuous 14 days. The drug dosage of high concentration of Mieyou Soup group, low concentrations of Mieyou Soup group, and gastric triad group were 12.4, 6.2 g/kg, and 0.279 8 mg/kg, respectively. Western Blot was used to detect the expression of HSP70 protein, and immunohistochemistry was employed to detect the expression of AQP4 protein. Results Compared with control group, the expression of HSP70 and AQP4 in model group significantly increased (P<0.05);compared with the model group, the HSP70 in high concentration of Mieyou Soup group, low concentrations of Mieyou Soup group, gastric triad group increased, the AQP4 in high concentration of Mieyou Soup group, low concentrations of Mieyou Soup group, gastric triad group decreased, with statistical significance (P<0.01). Conclusion Mieyou Soup may play a role in treatment of H.Pylori-associated gastritis mice of Pi-Wei hygropyrexia syndrome by raising the expression of HSP70, and reducing the expression of AQP4 protein expression.