Objective To investigate the clinical effects of treatment of chronic pulmonary heart disease (CPHD) at acute stage with sodium ferulate and Ciwujia injection. Methods 90 cases of CPHD at acute stage were recruited into treatment group 1, treatment group 2 and control group. The control group was treated with consistent inhalation of oxygen,antibiotics, and symptomatic therapies like relieving cough, removing sputum, and stopping wheeze. The treatment group 1was treated with sodium ferulate, Ⅳ 0.2g, once daily for successive 14days, in addition to the conventional treatment. The treatment group 2 was treated with Ciwujia Injection, 100ml Ⅳ, once daily for successive 14 days. Observe the curative effect and the changes of blood gas analysis indexes (PAo2, PaCO2, SAO2) and bemorheological indexes (whole blood high-cutting viscosity, whole blood low-cutting viscosity, whole blood recovery viscosity, erythrocyte aggregation index, and HCT) before and after treatment. Result Compared with the control group, both treatment groups got improvement in blood gas analysis indexes and hemorheological indexes and curative effect, but no significant difference between the two groups (P＞0.05).Conclusion both sodium ferulate and Ciwujia injection had good results in treating CPHD at acute stage, and there was no difference between the two medicines in terms of curative effects.

Objective To investigate the relationship of antishock effect of arginine vasopressin(AVP) on hemorrhagic shock and its relationship with Rho kinase.Methods Hemorrhagic shock(40 mmHg for 2 h) Wistar rats were treated respectively by AVP(0.4 U/kg),Rho kinase specific inhibitor,Y-27632(30 ?g/kg),or these 2 reagents.The pressor effect of norepinephrine(NE) on these rats and the contractility of their isolated superior mesenteric artery(SMA) were observed.Isolated SMAs from hemorrhagic shock rats were adopted to observe the effects of AVP on vascular reactivity and calcium sensitivity and its relationship to Rho kinase with an isolated organ perfusion system.Results AVP at the concentration of 0.4 U/kg significantly improved the pressor effect of NE and the contractile response of SMA.While,Y-27632(30 ?g/kg) abolished these beneficial effects of AVP.The vascular reactivity and calcium sensitivity of SMA were significantly decreased following hemorrhagic shock.AVP at the concentration of 0.5 and 5 nmol/L significantly increased the decreased vascular reactivity and calcium sensitivity.These effects of AVP were abolished by Y-27632(10 ?mol/L).Conclusion Rho kinase may take part in the action of AVP on hemorrhagic shock via improving shock induced vascular hyporeactivity and calcium desensitization.

Objective To investigate the prevalence of subclinical hepatic encephalopathy(SHE) in patients with cirrhosis. Methods One hundred and seventy five consecutive cirrhotic patients(mean age 53 years, range 27～72) without any overt clinical encephalopathy were screened for SHE using number connection test A(NCT A) and symbol digit test(SDT) with age corrected normal value, which have been developed in 356 persons without liver disease and are defined as the mean?2 standard deviation. Results Fifty patients(28.6%) were abnormal in both NCT A and SDT, 16(9.1%) were abnormal only in SDT and 34(19.4%) only in NCT A. Taken together, two tests diagnosed SHE in 100 patients(57.1%). The prevalence of SHE increased from 46.8% and 53.0% in Child Pugh grade A and B, to 76.6% in Child Pugh grade C. Conclusions SHE was found in 57.1% of cirrhotic patients without overt clinical encephalopathy, which was linked to the severity of liver cirrhosis.

Objective To assess the incidence of noctu rnal acid breakthrough(NAB) and its' relationship with Helicobacter pylori(H. pylori) infection in patients with duodenal ulcer. Methods Forty duodenal ulcer patients were randomly allocated in to five groups. Patients were treated by intravenous injection of omeprazole 40 mg twice daily(group 1), once daily(group 2), omeprazole 20 mg twice daily oral ly(group 3), omeprazole 20 mg once daily orally(group 4), and intravenous inject ion of cimetidine 600 mg twice daily (group 5) all for 5 days. Intragastric pH o ver 24 hours was consecutively recorded on the fifth day for each patient. Results The mean intragastric pH, median intragastric pH, nocturn al mean pH and nocturnal median pH in group 1(6.9?0.7,7.3?0.8,6.8?0.9,7.1? 0 .7) were significantly higher than those of group 2 (5.3?1.6,5.6?1.7,4.9?1. 5,4.3?1.7),group 4(4.8?0.7,4.8?1.0,4.7?0.8,4.5?0.8), and group 5(4.4?2.4 ,4.5?2.5,4.6?2.7,4.3?2.1), but not higher than group 3(6.2?0.7,6.3?0.8,6. 4?1.1,6.4?0.8). High intragastric pH was produced in all five groups. The frac tion time of pH below 4.0 in group 1(3.1%) and group 3(4.5%) were significantly fewer than that in the other three groups(group 2,27.8%; group 4, (32.4)%, and group 5,48.2%) respectively. NAB occurred in 1 patient from two omeprazole twice dai ly groups(6.3 %, group 1 and 3) and in 9 patients from two omeprazole once daily groups((56.3 %,) group 2 and 4,P

Objective To evaluate the clinical application of fecal elastase test in exocrine insufficiency of pancreatic disease. Methods The fecal elastase 1 was detected by ELISA method in 55 patients with chronic pancreatitis, 21 with pancreatic cancer and 25 with nonpancreatic digestive disease, and the urine BT PABA was measured by DACA method simultaneously. Results The fecal elastase 1 and urine BT PABA excretion in patients with chronic pancreatitis and pancreatic cancer were much lower than those in patients with nonpancreatic disease ( P

Objective To assess the incidence and management of nocturnal acid breakthrough (NAB). Methods Forty patients with duodenal ulcer confirmed by gastroscopy were randomly divided into five groups, eight patients in each group. Patients were treated by the following strategies for a course of 5 days: group A (omeprazole 20 mg per day orally in the morning), group B (omeprazole 20 mg twice a day orally in the morning and at 4 p.m), group C (intravenous injection of omeprazole 40 mg twice a day in the morning and at 4 p.m), group D (omeprazole 20 mg per day orally in the morning plus ranitidine 150 mg at bed time) and group E (omeprazole 20 mg twice a day orally in the morming and at 4 p.m plus ranitidine 150 mg at bed time) respectively. Intragastric pH over 24 hours was recorded on the morning of the fifth day for each patient. Results In comparison with that in group A, intragastric pH was higher in the other four groups. The mean intragastric pH and mean nocturnal pH each in group B (6.2?0.7, 6.4?1.1), group C (6.9?0.7, 6.8?0.9), group D (6.0?0.7, 5.9?0.7) and group E (5.8?0.5, 6.1?0.5) were significantly higher than those in group A (4.8?0.7, 4.7?0.8, P

0.05). However in OAC group, there were significant differences between EM and IM(P0.05). Conclusions RAC and OAC triple therapy could eradicate H. pylori effectively. The efficacy of rabeprazole-based triple therapy was less affected by the CYP2C19 genotype. The eradication rates of H. pylori in PM and IM were higher than that in EM.

Objective To evaluate the diagnostic efficacy of double-balloon push enteroscopy in small bowel disorders. Methods From July 2003 to March 2004, 38 patients with presentation of gastrointestinal upset and underwent a previous negative gastroscopy, colonoscopy, gastrointestinal barium and/or angiography were enrolled in this study. Enteroscopy via oral or rectum was done in 30 patients while in the other 8 patients full access to the small bowel was attempted by the two-way method, firstly via upper GI and then the lower GI. Results Positive diagnostic yield was made in 33 patients (86. 8% ). These disorders included Crohn's disease (7/38) , multiple ulcerations (5/38) , arteriovenous malformation (4/38) , multiple diverticula (4/38) , varices (3/38) , malignant stromal tumor (2/38) , ileitis (2/38) , and 1 case in each of moderate-differentiated adenocarcinoma, Ankylostoma duodenale, ascariasis, eosinophilic enteritis, anas-tomotic stricture and tuberculosis. The procedures were carried out satisfactorily in all patients but 2 failed from the intolerance of patients. Complication never occurred. Conclusion Double-balloon push enteroscopy has the superiority in direct visualization of whole small intestine with high positive findings and safety but with high technical demand in manipulation.

Objective To evaluate the efficacy of high intensity focused ultrasound (HIFU) combined with ultrasound contrast agent on rabbit liver, and to investigate the possibility of ultrasound contrast agents enhancing the effect of HIFU on rabbit liver. Methods Thirty-two rabbits were averagely divided into two groups according to their body mass. Rabbits in group Ⅰ were irradiated by HIFU alone on the liver, and those in group Ⅱ were treated by irradiation of HIFU after intravenous injection of a ultrasound contrast agent. The used treatment time, frequency, power and the distance from focus to the skin surface were identical in the two groups. The changes of ultrasound image were recorded at the 20 s, 2 min and 5 min after treatment. Four rabbits in each group were slaughtered for morphological and pathological examination immediately and on the 2nd, 3rd and 7th day after the treatments, respectively. Results The ultrasonic gray scale differenced in the HIFU alone group were ( 20.12? 12.4)s (20 s), ( 16.8? 9.3)min (2 min) and ( 15.1? 11.9)min (5 min). Compared with those in the enhanced HIFU group were ( 63.9? 29.4)s, ( 60.0? 25.9)min, ( 59.3? 28.7)min, respectively(P

Teaching of clinical skills is an important bridging phase from preclinical medicine to clinical practice.It is also an important element of medical students'clinical skills training.According to the character of internal medical cardiology,we should enhance the training of their clinical thinking ability,medical communication competence,and clinical operating ability to get satisfactory teaching effect.