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.

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.

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 observe the effect of capsaicin on lipid deposition in liver cells and the expression of autophagy,to provide new ideas and targets for the study of fatty liver disease.Methods The model of nonalcoholic fatty liver disease (NAFLD) was established by inducing LGF cell line of liver primary cells with oleic acid (40 μg/mL).The experiment was divided into blank control group,oleic acid group,capsaicin group[oleic acid--capsaicin(100 μmol/L)].The level of intracellular lipid was detected by oil red O staining and triglyceride (TG) kit.Western bolt was used to detect the expression level of autophagy marker molecule p62 and LC3,and to calculate the ratio of LC3 Ⅱ/LC3-Ⅰ.Results After treated with 40 μg/mL oleic acid for 24 h,the oil red O staining showed that orange-red lipid droplets were found in the oleic acid group,but there was no obvious orange-red lipid droplet formation in the blank group,which suggesting that the NAFLD cell model was established successfully by using 40 μg/mL oleic acid in vitro.Oil red O staining was observed,the cells in the capsaicin group were significantly less than the oleic acid group,and the content of triglyceride in the liver cells was significantly lower than that in the oleic acid group(P＜0.05).Western bolt test results showed that capsaicin group p62 protein levels were significantly lower compared with the oleic acid group(P＜0.05),while the LC3-Ⅱ/LC3-Ⅰ ratio was higher than that of oleic acid group(P＜0.05).Conclusion NAFLD model was established by inactivating LO2 cell line with oleic acid in vitro.Capsaicin stimulated NAFLD cells,upregulated the autophagy level of NAFLD cells and reduced intracellular lipid deposition,but the specific mechanism need further study.

75%). Immunoglobulin ? and ? chains as well as TTR positive deposits were not demostrated in the accumulated amyloid material. There was neither TTR nor apolopoprotein A1 coding gene mutation detected in the proband and her son. Conclusion: The pathological findings demonstrated existence of a FAP. However, the immuno pathological and genetic results could not classified the type of this FAP family. Further genetic studies are required to identify it.

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.

By using the diagnosis related groups(DRGs) method, we analyze and compare the rationality and feasibility of outcomes and human resources distribution of clinical specialties and health care professionals.It may increase the hospital management levels and feasibility.The introduction of DRGs for the majority of hospital management may enhance the performance evaluation and human resource levels in the hospitals.

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 analyze quantitatively the safety and efficacy of statin therapy in acute phrase for acute ischemic stroke with the method of meta-analysis.Methods We performed a systematic literature search including the Cochrane Library,MEDLINE and EMBASE for published trials about statin therapy and the outcomes of acute ischemic stroke.Then we performed a meta-analysis with included studies to investigate the association between statin therapy and clinical outcome and mortality.All of the data were pooled and meta-analyzed by Cochrane Collaboration RevMan 5.3 meta-analysis software.Statistical heterogeneity between studies was evaluated by the chi-square and I-square tests.Forest plots were used to summarize study data and Egger tests were used to assess publication bias.Results A total of 27 studies including 52 034 patients,comprising 19 212 statin users and 32 822 non-statin users met the inclusion criteria,4 studies were randomized controlled trials (RCTs),and 23 were observational trials (OTs).Both pre-or post-stroke statin use was associated with reduced mortality.Statin use is associated with favorable functional outcome at hospital discharge and on the ninetieth day regardless of initiation time for pre-stroke group and post-stroke group.The results from observational trials were consistent with randomized controlled trials.There was no evidence of publication bias for all comparisons by Egger tests.Conclusions Statin therapy before or after AIS is safe and effective.