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.

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.

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 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.

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.