Objective To investigate oxygen nebulizer usage among inpatients in an upper first‐class hospital so that this de‐vice can be used by medical personnel and patients properly .Methods Totally 409 patients were investigated about the usage of the device from May 12th to 30th 2014 ,whose outcomes were analyzed by Excel2007 software .Results The total liquid volume of in‐halation on prescription was much larger than the favorable one ,ranging from 4 to 6 mL .And the Oxygen flow ,ranging from 2 .5 to 3 .5 L/min ,was much lower than the normal flow (ranging from 6 to 8 L/min) .In addition ,all patients failed to breathe normally with occasional deep breaths and failed to gargle timely after corticosteroid inhalation .Only 3% patients cleaned their faces after corticosteroid inhalation ,43 .5% patients sit in an upright position ,44 .0% patients kept the nebulizer vertical during treatment .The accuracy rates of mouthpiece position ,the right time to stop nebulizer therapy ,rinsing the nebulizer with sterile or distilled water and allowing to air dry were 95 .1% ,99 .2% ,and 99 .3% ,respectively .Conclusion There are many common patient use nebulizer incorrectlly in the upper first‐class hospital ,and education and guidance by medical personnel should be strengthened .

Advances in mechanism and application of the heating effect in breeding of microorganism are reviewed in this paper. Heat produces mutagenesis effect and screening effect. Heating mutagenesis effect is occurred through the substitution of G-C base pair induced by heat, and heating screening effect produces higher forward mutation rate induced by other mutagens.

One of the hot spots of nanomaterials research is the preparation of carbon-dots ( C-dots) by simple steps with cheap raw materials and looking for its potential application. In this study, coal-based C-dots was prepared from coal mined of Wucaiwan in Xinjiang by mixed acids ( H2 SO4+HNO3 )/ultrasound treatment, and at the same time of structural characterization, the coal-based C-dots were used as fluorescent probe to detect metal ions in water. It was found that the coal-based C-dots were polycyclic aromatic hydrocarbons with particle size of (8±4) nm linked with oxygen-containing groups such as nitro group, possessing the annulus wall of multilayer graphene fragment structures built up by sp2 carbons. This endowed the coal-based C-dots with good dispersity in water, high absorbance and strong fluorescence. The coal-based C-dots were used as viable probes in that their fluorescence was selectively quenching by CuⅡ. The finding was exploited to design a fluorometric assay for CuⅡ with a detection limit of 9. 6 nmol/L.

BACKGROUNDCathepsin S and its endogenous inhibitor cystatin C are implicated in the pathogenesis of atherosclerosis, especially in the plaque destabilization and rupture leading to acute coronary syndrome. However, whether circulating cathepsin S and cystatin C also change in association with coronary plaque morphology is unknown yet.

METHODSWe recruited 98 patients with unstable angina (UA, n = 6) or stable angina (SA, n = 2) who had a segmental stenosis resulting in > 20% and < 70% diameter reduction in one major coronary artery on coronary angiography. Thirty-one healthy subjects served as controls. Intravascular ultrasound (IVUS) was used to evaluate plaque morphology. Plasma cathepsin S and cystatin C were measured as well.

RESULTSAt the culprit lesion site, plaque area ((7.85 +/- 2.83) mm(2) vs (6.53 +/- 2.92) mm(2), P = 0.027), plaque burden ((60.92 +/- 11.04)% vs (53.87 +/- 17.52)%, P = 0.025), remodeling index (0.93 +/- 0.16 vs 0.86 +/- 0.10, P = 0.004) and eccentricity index (0.74 +/- 0.17 vs 0.66 +/- 0.21, P = 0.038) were bigger in UA group than in SA group. Plasma cathepsin S and cystatin C were significantly higher in patients than in controls (P < 0.01). Plasma cathepsin S was higher in UA group ((0.411 +/- 0.121) nmol/L) than in SA group ((0.355 +/- 0.099) nmol/L, P = 0.007), so did the plasma cystatin C ((0.95 +/- 0.23) mg/L in UA group, (0.84 +/- 0.22) mg/L in SA group; P = 0.009). Plasma cathepsin S positively correlated with remodeling index (r = 0.402, P = 0.002) and eccentricity index (r = 0.441, P = 0.001), and plasma cystatin C positively correlated with plaque area (r = 0.467, P < 0.001) and plaque burden (r = 0.395, P = 0.003) in UA group but not in SA group.

CONCLUSIONSPlasma cathepsin S and cystatin C increased significantly in UA patients. In angina patients, higher plasma cathepsin S may suggest the presence of vulnerable plaque, and higher plasma cystatin C may be a clue for larger atherosclerotic coronary plaque.

Adult ; Aged ; Aged, 80 and over ; Cathepsins ; blood ; Coronary Artery Disease ; blood ; diagnostic imaging ; pathology ; Cystatin C ; blood ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional ; methods

OBJECTIVETo analyze the reason of coronary artery aneurysmal dilations in patients after sirolimus-eluting stent implantation.

METHODSLate localized aneurysmal dilations post PCI were evidenced in 4 patients (age 69.5 +/- 3.5 years, 3 males) during follow-up (24.8 +/- 1.8 months). Nine stents were implanted into 7 diseased vessels: 5 Cypher select stents in LAD; 2 Firebird stents and 1 Pixel stent in LCX; 1 Cypher select stent in RCA. Clopidogrel (75 mg/d) was used for one year.

RESULTSAll stents were implanted successfully after predilation. No acute or subacute in-stent thrombosis and MACE was recorded. Follow-up angiogram imaging at 12 months after stenting was normal in all patients. Chest pain reoccurred in these 4 patients at 16, 18, and 22 months post stent implantation and patients were rehospitalized and treated with clopidogrel, asprine, and intravenous nitroglycerin. Angiography showed aneurysmal segment at the stented site of LAD in 3 patients, and at RCA in 1 patient. The symptom disappeared after 3 days intravenous tirofiban treatments and discharged without in-hospital complications. Patients remained symptom-free 3 - 6 months post discharge.

CONCLUSIONLate localized aneurysmal dilations after sirolimus-eluting stents are related to reoccurred angina pectoris post PCI.

Aged ; Coronary Artery Disease ; therapy ; Coronary Restenosis ; therapy ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Sirolimus ; administration & dosage

Objective To study the routine examination of Aconitum sinomontanum Nakai and determine the contents of lappacontine and ranaconitine; To provide basis for establishing the quality standard of Aconitum sinomontanum Nakai.Methods Aconitum sinomontanum Nakai were collected from different areas.A method of TLC was used for qualitative discrimination. The methods in the Chinese Pharmacopoeia were adopted for the determination of moisture content, ash content and extractives. Determination of lappacontine and ranaconitine were performed by HPLC. Results The TLC showed that the spots were clear and the separation was good. Individual provisional standards:the moisture,total ash and acid-insoluble ash content of Aconitum sinomontanum Nakai were not more than 11.0%, 12.0%, and 7.0%, respectively; water soluble and alcohol soluble extractives were not less than 18.2% and 10.6%,respectively.The content of ranaconitine and lappacontine in Aconitum sinomontanum Nakai were not less than 0.125% and 0.815%, respectively. Conclusion The method established by the study is accurate and reliable,and can be used for quality evaluation of Aconitum sinomontanum Nakai.

OBJECTIVETo investigate the clinical efficacy of noninvasive positive pressure ventilation (NPPV) in treatment of patients with arrhythmia complicated by sleep apnea syndrome (SAS).

METHODSOne hundred and thirty-five arrhythmia patients with polysomnography diagnosed SAS were randomly divided into NPPV group (69 cases) and control group (66 cases), the NPPV group was treated with standard medications and NPPV, and the control group was treated with standard medications. SAS related parameters were compared between the groups after 3 months therapy.

RESULTS(1) Epworth sleepiness scale (ESS) score, apnea-hypopnea index (AHI) and arousal index were significantly lower (8.25 ± 5.41 vs.4.08 ± 3.43, 39.95 ± 7.32 vs. 4.71 ± 1.80 and 39.69 ± 4.40 vs. 15.20 ± 2.05, P < 0.01) while not rapid eye movement (NREM) III and rapid eye movement stage of sleep time and lowest pulse oxygen saturation (LSaO2) were significantly higher in NPPV group than in control group [(4.53 ± 2.10)% vs. (16.78 ± 2.59)%,(8.37 ± 1.380)% vs. (15.25 ± 1.41)%, (77.15 ± 6.72)% vs. (93.35 ± 2.03)%, P < 0.01] after 3 months therapy. (2) Incidence of Sinus bradycardia, sinus tachycardia, sinus arrest, atrial premature beats, ventricular premature beats, paroxysmal atrial tachycardia, paroxysmal ventricular tachycardia, atrial fibrillation, II-III degree atrioventricular block, ST-T segment changes were reduced from 57.4%, 44.4%, 7.4%, 20.4%, 13.0%, 36.5%, 12.0%, 8.3%, 37.0%, 53.7% to 4.6%, 1.9%,0.0%, 3.7%, 2.8%, 7.0%, 0.9%, 0.0%, 1.9%, 4.6% (all P < 0.05) and the total number of arrhythmias happened at night were significantly lower (all P < 0.05) while the heart rate variability (HRV) were significantly higher (P < 0.01) in NPPV group than in control group; AHI was positively while LSaO2 was negatively correlated with the total night arrhythmia number (P < 0.01).

CONCLUSIONNoninvasive positive pressure ventilation is an effective therapy strategy for treating patients with arrhythmia complicated by sleep apnea syndrome.

Adult ; Aged ; Arrhythmias, Cardiac ; complications ; prevention & control ; Female ; Humans ; Male ; Middle Aged ; Noninvasive Ventilation ; Positive-Pressure Respiration ; Sleep Apnea Syndromes ; complications ; therapy

OBJECTIVETo investigate the association of polymorphisms of metabolic and DNA repair enzyme genes and DNA damage in peripheral blood lymphocytes in coke-oven workers.

METHODSOne hundred and forty-four coke-oven workers and 50 controls were recruited in this study. Urinary 1-hydroxypyrene (1-OHP) levels were measured as the internal dose of polycyclic aromatic hydrocarbons exposure. DNA damage was detected by alkaline comet assay, and the value of 1.74 was used as the cut-off value to determine whether the individual's DNA damage was positive. The genotypes of CYP1A1, CYP2E1, GSTP1, NQO1, mEH and XRCC1 were determined by PCR-based methods. With adjustment for urinary 1-OHP, age, sex, multiple analysis of covariance was used to study the association between genotypes and the ln-transformed olive TM and multiple logistic regression was used to calculate the adjusted OR and the 95% CI for the risk of DNA damage.

RESULTSIn 144 coke-oven workers, with adjustment for urinary 1-OHP, coking history and sex, the olive TM was significantly higher with XRCC1 280His allele than those with Arg allele (5.6 vs. 2.8, P < 0.01). The subjects with XRCC1 280His allele also have significantly higher risk for DNA damage than subjects with Arg allele (adjusted OR = 2.66, 95% CI = 1.00-7.14, P = 0.05) and the subjects with GSTP1 104Val allele have higher risk for DNA damage than subjects with Ile allele (adjusted OR = 1.90, 95% CI = 0.94-3.85, P = 0.07).

CONCLUSIONXRCC1 and GSTP1 polymorphisms might influence the susceptibility of DNA damage in occupational PAH-exposed coke-oven workers.

Adult ; Case-Control Studies ; Coke ; poisoning ; Comet Assay ; Cytochrome P-450 CYP1A1 ; genetics ; Cytochrome P-450 CYP2E1 ; genetics ; DNA Damage ; DNA Ligase ATP ; DNA Ligases ; genetics ; DNA Repair Enzymes ; genetics ; Female ; Genotype ; Glutathione S-Transferase pi ; genetics ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; NAD(P)H Dehydrogenase (Quinone) ; genetics ; Occupational Exposure ; adverse effects ; analysis ; Polymorphism, Genetic

OBJECTIVETo investigate the anticoagulant efficacy and safety of argatroban for patients undergoing elective percutaneous coronary intervention (PCI).

METHODSA total of 300 consecutive patients with coronary heart disease undergoing elective PCI were enrolled and randomized into heparin group (100 U/kg via artery sheaths, n = 150) and argatroban group (200 µg/kg bolus, followed by 350 µg·kg(-1)·h(-1) i.v. infusion, n = 150). The primary efficacy endpoint was the activated clotting time (ACT) results (10 min and 60 min after anticoagulant administration and at the point at the end of PCI). The additional dosage of heparin or argatroban was given if the ACT value during PCI procedure < 250 s. Activated partial thromboplastin time (APTT) was also measured at pre-procedure, 10 min after anticoagulant injection and 60 min after PCI. The primary safety endpoint was thrombosis and hemorrhagic events during PCI procedure and hospital stay.

RESULTSAll patients in the two groups attained the target ACT ( ≥ 250 s), and ACT in heparin group was significantly prolonged [(343.32 ± 44.70) s vs. (289.60 ± 20.88) s, P < 0.01], at 10 min after anticoagulation injection. ACT was similar between the two groups at 60 min after anticoagulation injection [(291.26 ± 46.79) s vs. (288.40 ± 21.61) s, P > 0.05]. The ACT value in argatroban group was similar at 10 min and 60 min after injection (P > 0.05). Supplemental anticoagulant was needed for 13 (8.7%) patients in heparin group and 2 (1.3%) patients in argatroban group because of ACT under 250 s (P < 0.05) . At the end of PCI procedure, ACT in heparin group was significantly shorter than in argatroban group [(247.16 ± 41.38)s vs. (278.65 ± 20.51) s, P < 0.01]. APTT in heparin group was significantly prolonged than in argatroban group not only at 10 min point [(182.16 ± 4.37) s vs. (81.69 ± 21.49) s, P < 0.01] after anticoagulant injection but also at the point of 60 min after PCI procedure[(169.13 ± 6.35)s vs. (56.21 ± 15.68) s, P < 0.01]. There was no thrombus event in two groups and no bleeding event in argatroban group, and there was three bleeding events in heparin group [2.0% (3/150) vs.0, P > 0.05].

CONCLUSIONArgatroban is an effective and safe anticoagulation agent during elective PCI procedure, anticoagulant efficacy and risk of bleeding side effects of argatroban are similar to heparin.

Adult ; Anticoagulants ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Pipecolic Acids ; therapeutic use ; Treatment Outcome

Adolescent ; Adult ; Anesthetics, Intravenous ; Electroencephalography ; Female ; Humans ; Hypothermia, Induced ; methods ; Male ; Prospective Studies ; Status Epilepticus ; pathology ; therapy ; Young Adult