Objective To investigate and compare the effects of sustained inflation (SI) and pressure controlled ventilation (PCV) on lung recruitment in patients with ARDS, and on hemodynamics and respiratory mechanics of patients. Methods Ten patients with ARDS were included in this randomized clinical trial ( RCT), and SI (40 cmH20, 40s) and PCV (20 cmH20, 2 min) were successively applied to each patient under sedation, non-muscle relaxation state. There was a elution period between two types of recruitment maneuver (RM). Parameters of respiratory mechanics, gas exchange and hemodynamics were measured before RM (T0), 5 min after RM (T2) and one hour after RM (T3). Parameters of respiratory mechanics and hemodynamics were measured during the period of RM (Tl). Results (1) The PaO2 at T2 and T3 increased significantly in comparison with that at To ( P < 0.05), and there was no significant difference in PaO2 between two types of RM (P > 0.05). There were no significant differences in PaCO2 between two types of RM at each interval (P > 0.05). (2) The cardiac index ( CI) at T1 decreased significantly compared with that at To in two types of RM (P < 0.05), but there was difference in CI between two types of RM (P > 0.05). There were no differences in MAP and HR at these intervals (P > 0.05). (3) The functional residual capacity (FRC) at T2 and T3 increased significantly in comparison with that at To in two types of RM (P < 0.05). The static compliance (Cs) at T1 improved significantly (P < 0.05), but there was no difference in Cs between two types of RM ( P > 0.05). There was no difference in plateau pressure (Pplat) at all intervals (P >0.05). Conclusions The oxygenation, FRC, and Cs improve significantly in both SI-RM and PCV-RM, and the effects of two types of RM are similar. The SI-RM and PCV-RM have the similar impact on circulatory system during RM.

One hundred and fifteen patients with rheumatic mi- tral stenosis were treated with Percutaneous Balloon Mi- tral Valvuloplasty (PBMV) from August,1988 to May, 1993.110 patient (94.5%) had successful operations. The observations showed that PBMV can enlarge the stenostic mitral orifice area over 1 time (from 1.04?0. 26cm to 2.08?0.32 cm,P

OBJECTIVE To study the prevention strategy of community-acquired pneumonia(CAP) for retired old cadres of PLA.METHODS We adopted the first and second prevention strategy of disease to deduce the frequency for CAP.RESULTS The old cadres were divided into common prevention group and important prevention group by evaluating their body condition.The common prevention group was taken the first prevention strategy:healthy education,inhabit surroundings improvement and proper exercises.The second prevention was carried out to personnel who have chronic disease of respiratory organs which included eliminating the risk factors and making efforts to find, diagnose and treat infection as early as possible.CONCLUSIONS The first and second prevention is an effective working mode which improves the level of CAP prevention.

Objective To understand the situation of nosocomial infections, the distribution of important pathogens of affected patients and the uses of antibacterial drugs.Methods The cross-sectional survey was ap-plied.Before the survey, the investigators were trained by the professionals of the department of hospital infection management.Medical records were reviewed one by one, checked with bedside physical examination.Results In this survey, 283 inpatients were investigated, with an actual check rate of 100%.Two inpatients were affected with nosocomial infection with the prevalence rate of 0.71%.There were two cases of infections (0.71%).Conclusion Investigation of the prevalence rate of nosocomial infection was an important means to monitor the hospital infection, which can monitor specifically, minimize the incidence of nosocomial infection and ensure medical safety by obtaining the information of the departments with high-risk nosocomial infection, the main infectious sites and pathogens.

Objective To investigate the correlation between cerebral artery stenosis (MCAS) and mild cognitive impairment (MCI).Methods Continuous selected 636 cases of 50-80 years old inpatients or outpatients who examined by transcranial color Doppler ultrasound (TCD) in April 2012 to April 2013 in our hospital.Keep the mini-mental state examination (MMSE) and clinical dementia rating (CDR) as the evaluation of cognitive function.Results Detected 124 cases of MCAS patients (MCAS group) and 512 cases of non-MCAS patients (non-MCAS group).Forty-four cases MCI were detected in MCAS group with the prevalence rate was 35.5％(44/124),and 114 cases of patients with MCI were detected in non-MCAS group with the prevalence rate was 22.3％ (114/512),the difference was statistically significant (P ＜ 0.05).Single factor analysis showed that there were no significant difference between two groups in waist circumference,hypertension,coronary heart disease,hyperlipidemia,smoking,diastolic blood pressure and total cholesterol,uric acid,fasting glucose,C-reactive protein (P ＞ 0.05); There were significantly different between two groups in age,gender,education level,MCAS,history of diabetes,systolic blood pressure and triglyceride,low density lipoprotein-cholesterol,high-density lipoprotein-cholesterol(P ＜ 0.05).Multiple factors analysis showed that the MCAS (OR =1.899,95％ CI 1.224-2.946),history of diabetes (OR =1.764,95％ CI 1.191-2.612),systolic blood pressure(OR =1.012,95％ CI 1.003-1.022),gender (OR =0.558,95％ CI 0.380-0.821),and age (OR =1.029,95％ CI 1.010-1.049) was the independent risk factor for MCI.Conclusion The MCAS related with MCI occurrence and development.

Objective To observe the expression of brain-derived neurotrophical factor (BDNF) in injury spinal cord after transplantation olfactory ensheathing cells (OECs), and to investigate the mechanism of OECs repairing spinal cord injury.Methods OECs from GFP transgenic rats were separated and cultured for transplantation. Spinal cord injury rats were separated two groups by random digits table. In experimental group, OECs suspension were transplanted into injured spinal cord following spinal cord injury. In control group, DMEM was transplanted into the injured spinal cord after spinal cord injury. Motor function was evaluated per week after transplantation. The expression levels of BDNF mRNA and protein were detected by using RT-PCR and immunohistochemistry respectively, and compared with those from normal SD rats.Results Motor function of two groups was improved gradually after transplantation. The motor function scores in experimental group was obviously higher than in control group at 21st day after transplantation (P<0.05). A lot of survival GFP OECs distributed around impaired myeloid tissue. At 21st day after transplantation, BDNF mRNA and protein expression in experimental group were strongest (P<0.05), and stronger in control group than in normal group (P<0.05).Conclusion The transplantation of OECs can repair the injured spinal cord by increasing the expression of BDNF mRNA and protein to improve local microenvironment.

Objective To establish an animal model of severe bone marrow type acute radiation sickness in the BALB/c mice and to provide a good foundation for further investigation of severe bone marrow type acute radiation sickness.Methods BALB/c mice were given 6.0 Gy 60Co γ-rays total body irradiation.The mice were observed twice a day.The changes in body weight,peripheral blood cell counts were recorded once every three days.Histopathological sections of femur were prepared to observe the histomorphological changes.Bone marrow cells were collected to perform colony cultivation on day 1 before irradiation,and 14 d,28 d after irradiation.Results The mice were less active three days after irradiation,but there were no vomiting and loose stools.The white blood cell counts were dropped to the nadirs (3.0 ％) 11 days after irradiation and recovered to 53.7 ％ on day 28 after irradiation.The platelet counts were dropped to the nadirs (8.1％) 14 days after irradiation and recovered to 60.4 ％ on day 28 after irradiation.Histopathological section showed that the bone marrow cavity was almost empty on day 14 after irradiation.Semi-solid bone marrow cell culture results also demonstrated that CFU-GM and CFU-Mix were obviously decreased.They were not yet fully recovered on day 28 after irradiation.All mice were still alive two months after irradiation.Conclusion A murine model of severe bone marrow type acute radiation sickness has been successfully established by exposure to 6.0 Gy 60Co γ-rays.

Objective To discuss the expression and mutation of β-catenin gene in breast carcinoma.Methods 119 breast carcinomas, 72 adenosis of breast tissues and 40 normal breast tissues were studied.Using immunohistochemistry studies to detect the expressions of β-catenin, then analyzing their relationship with the clinicopathological features of breast carcinomas. Gene mutation of β-catenin (exon 3) in 44 cases of breast carcinoma were analyzed by polymerase chain reaction (PCR) and then by direct sequencing.ResultsIn 40 cases of normal breast tissues, epithelial cells showed equally strong membranous of β-catenin protein at the cell-cell boundaries. The abnormal rate of β-catenin in breast carcinomas (78.15 %) was much higher than that of adenosis of breast tissues (44.44 %), the significant correlation was found (P＜0.01). The abnormal expression of β-catenin was associated with lymph node metastasis (P=0.031). Mutation of β-catenin gene was not detected in 44 cases of breast carcinoma, while the abnormal rate of β-catenin in 44 cases of breast carcinoma was 77.30 %. Conclusionβ-catenin abnormal expression could be considered as an useful marker for determining metastasis and prognosis of human breast carcinoma and for guiding treatment. β-catenin abnormal expression is not caused by β-catenin gene mutation, maybe by other mechanisms. It needs further study.

Objective To study the effects of different anesthesia methods on postoperative changes in T-lymphocyte subsets and IL-6、IL-10、TNF-α in the patients undergoing operation of stomach carcinoma.Methods 60 patients with stomach carcinoma were randomly divided into group I(general anaesthesia)and Ⅱ(general combined epidural anesthesia).The level of T-lymphocyte subsets and IL-6、IL-10、TNF-αt were respectively detected and compared before anesthesia,2 h after anesthesia,ld and 6 d after operation.Results CD3+ 、CD4+ 、CD4+/CD3+ decreased,but IL-6 increased at the end of 2 h after anesthesia,l d after operation compared with those before anesthesia(all P＜0.05).While IL-10、TNF-α had no statistical significance(all P＞0.05).At 6 d after operation,the values recovered to the level before anesthesia in two groups.Conclusion The immune function in patients with gastric cancer decreaseed after anesthesia,it was more serious in geteral anaesthesia than that of general combined epidural anesthesia.But anesthesia had little influence on inflammatory response.

Objective To explore the Influence of different health education approaches to standard anticoagulation of non-valvular atrial fibrillation. Methods 400 patients with NVAF were randomly divided into the research group (n=200) and the control group (n=200). Baseline clinical information was recorded. Both groups were given regular education and treatment. The control group was randomly divided into two subgroups. One subgroup (patients or/and family members) was given knowledge lectures of atrial fibrillation, atrial fibrillation anticoagulant, and application of warfarin. The other was given the knowledge through booklets. Standard anticoagulation fulfillment rate, ischemic stroke, other events of artery embolism, major bleeding, minor bleeding and death in the two groups were observed after 1 year. The cost for different education approaches was also compared between the 2 subgroups. Results (1)In the research group, standard anticoagulation fullfillment rate (40.53%) was higher than that of the control group(15.96%) (P<0.01). The rate of ischemic stroke (2.63%) was also lower than the control group (4.49%) (χ2=4.49, P<0.05). The death rate was lower in the research group than those in the control group, but minor bleeding rate was higher, without statistically significance (P>0.05).Other artery embolism rate , major bleeding, minor bleeding, death rate had no statistical difference. (2)Knowledge lecture group (10.8±1.0 min) spend more time than the booklet group (1.0±0.5 min) (P<0.01). The booklet group (5.1±1.1 yuan) costed more in terms of money than the knowledge lecture group (1.8±0.5 yuan) (P<0.01). (3)The knowledge lecture group showed higher standard anticoagulation fulfillment rate (47.96%) than that of booklet group (32.60%) (χ2=7.33, P<0.01). There was no statistical difference in ischemic stroke rate, other artery embolism rate, major bleeding rate, minor bleeding rate and the death rate. Conclusions Detailed, correct anticoagulant education and guidance can improve NVAF patients with standard anticoagulation, and reduce the risk of ischemic stroke. Knowledge lecture consumes more time but can improve the standard anticoagulation fulfillment rate.