BACKGROUND: Animal experiments showed that recruitment maneuver (RM) and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index ( EVLWI) in patients with acute respiratory distress syndrome (ARDS). METHODS: Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index (PaO2/FiO2), peak inspiratory pressure (PIP), Plateau pressure (Pplat), static pulmonary compliance (Cst) and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student's t test and Fisher's exact test were used to process the data. RESULTS: The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group (P<0.05). The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group (P<0.05). The EVLWI in the two groups showed downward trend after treatment (P<0.05), and the differences were signifcant at all time points (P<0.01); the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours (P<0.05 or P<0.01). Compared with pre-RM, hemodynamics changes during RM were significantly different (P<0.01); compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM (P>0.05). CONCLUSIONS: RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.

To evaluate the clinical efficacy and safety of Qinghouyan lozenge in the treatment of acute pharyngitis due to Lung-heat and Yin-deficiency, and compare with Qinghouyan oral Liquid. Totally 144 subjects were enrolled and randomly divided into two groups (72 in the test group and 72 in the control group). The participants in the test group were given Qinghouyan lozenge for 5 days, and those in the control group were given Qinghouyan oral Liquid for 5 days. The effectiveness evaluation indexes were pharyngalgia/odynophagia disappearance rate, overall efficacy of TCM syndromes, TCM syndrome scores, and single syndrome and sign disappearance rate. During the test, the safety was evaluated by vital sign, lab examination indexes and adverse events. The results for the full analysis set showed that the couth disappearance rate, the incidence rate of TCM syndromes, and the throat/uvula congestion disappearance rate of the test group were higher than that of the control group (P < 0.05), with significant differences in the changes in syndrome scores between the two groups (P < 0.05). Altogether 3 adverse events were observed in the test group while 6 adverse events in the control group, without significant differences in the adverse event rate between the two groups (P < 0.05), serious abnormal laboratory examinations and vital signs. In conclusion, Qinghouyan lozenge has better efficacy in treatment of acute pharyngitis due to Lung-heat and Yin-deficiency than Qinghouyan oral liquid, with good safety.
Acute Disease ; Double-Blind Method ; Humans ; Medicine, Chinese Traditional ; Pharyngitis ; drug therapy

OBJECTIVETo investigate the expression of uncoupling protein (UCP)-2, 3 mRNA in skeletal muscle of the scalded rats after escharectomy at different post scalding stages.

METHODSOne hundred and twenty Wistar rats were employed in the study, in which 8 served as normal control (C) and 112 were subjected to 30% TBSA 3rd degree scalding and then again, divided into 4 groups. The rats in A group were sacrificed on 8th, 24th, 96th, 120th and 168th post scalding hours (PSHs) without escharectomy. The rats in B group underwent escharectomy at 8 PSH, and those in C group underwent escharectomy at 24 PSH. All the rats in both groups were sacrificed on 96, 120 and 168 PSHs after escharectomy, Escharectomy was performed at 96 PSH in rats of D group, and they were sacrificed on 120 and 168 PSHs after escharectomy. The serum levels of leptin and TNFalpha, and the expression level of UCP2 mRNA were determined at all time points in all groups of rats.

RESULTS(1) The serum levels of leptin in A group were obviously lower than that in C group (P < 0.01) during 24 approximately 168 PSHs, while those in B, C and D groups were much higher than those in A group (P < 0.01) during 24 approximately 168 PSH. (2) The serum TNFalpha levels in A group at all time points were higher than that in control group, while that in B group at all time points were lower than that in A group (P < 0.05 or 0.01), and that in C group at 168 PSH was lower than that in A group (P < 0.05). (3) The UCP2 mRNA expression in skeletal muscle in A group was increased evidently since 8 PSH (P < 0.01), peaking at 24 PSH and lowering thereafter, while that in B and C groups at 168PSH was significantly lower than that in A group at the same time points (0.32 and 0.35 vs 0.71, P < 0.05). The trend of the change in UCP3 mRNA expression in skeletal muscle was similar to that of UCP2.

CONCLUSIONThe postburn up-regulation of UCP mRNA expression might play important roles in the increase of metabolic rate. Escharectomy during shock stage could lower down the expression of UCP2 and UCP3 mRNA expression, and it could be beneficial by lowering metabolic rate.

Animals ; Burns ; metabolism ; surgery ; Cicatrix ; metabolism ; surgery ; Ion Channels ; metabolism ; Male ; Mitochondrial Proteins ; metabolism ; Muscle, Skeletal ; metabolism ; RNA, Messenger ; metabolism ; Rats ; Rats, Wistar ; Time Factors ; Uncoupling Protein 2 ; Uncoupling Protein 3

OBJECTIVETo investigate the influence of escharectomy during shock stage on plasma lipid and free fatty acid levels in scalded rats.

METHODSThirty-two adult Wistar rats inflicted with 30% TBSA III degree scalding were employed as the model and were divided into normal control (NC), scalding control (SC) and treatment groups (T), and the latter was further divided into three sub groups according to the time of escharectomy, i.e. 8 postburn hour (PBHs) (T8), 24 PBHs (T24) and 96 PBHs (T96) groups. The rats were sacrificed at 168 PBHs. The postburn changes in the rat plasma lipid and free fatty acid levels were determined.

RESULTS1) There was significant increase in serum triglyceride (TG), cholesterol (CHO), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), apolipoprotein A (ApoA), apolipoprotein B (ApoB) and all the free fatty acids (FFAs) in the total serum FFAs excluding myristic acid (P < 0.05) at 168 PBHs in rats of all the T groups. 2) The serum levels of TG, CHO, ApoB, total FFA, lauric acid, palmitic acid, zoomaric acid, oleic acid and linoleic acid in T8 and T24 groups were evidently lower than those in SC group (P < 0.05). The plasma levels of VLDL, stearic acid and arachidonic acid in T8 were obviously lower than those in SC group (P < 0.05); 3) In T96 group, the serum levels of ApoB and lauric acid were significantly lower than those in SC group (P < 0.05), but all the other indices remained higher than those before injury.

CONCLUSIONThere was enhanced fat mobilization after severe burn injury. Escharectomy during shock stage might decrease fat mobilization, which was beneficial to the restoration of normal lipid metabolism.

Animals ; Burns ; blood ; surgery ; Fatty Acids ; blood ; Lipids ; blood ; Male ; Rats ; Rats, Wistar ; Shock, Traumatic ; blood ; surgery

OBJECTIVETo investigate the capacity for risk identification, assessment, and mitigation in public health emergency management in China.

METHODSFour provinces were randomly selected using stratified sampling. All the municipalities under these four provinces were assessed using the 3rd subscale (Risk Identification, Risk Assessment, and Risk Mitigation) of Preparedness and Response Capacity Questionnaire for Public Health Emergencies Used in Provincial or Municipal Governments, which was developed by the Center for Health Statistics and Information, Ministry of Health of the People's Republic of China.

RESULTSSixty of 66 questionnaires (90.91%) were collected. Among 60 investigated municipalities, 35 (58%) identified the potential public health emergencies, 17 (28%) assessed the risks for the identified emergencies, and 5 (8%) conducted risk assessments for the locally accident-prone factories, mines, corporations, and big establishments, 6 (10%) identified the priorities in public health emergency management based on risk assessment, 6 (10%) developed special prevention strategies for main public health emergencies, 3 (5%) assessed the vulnerability of local residents to public health emergencies, and 34 (57%) assessed or were assessing the preparedness and response capacity for public health emergencies in the past 2 years. The mean of standard total score for risk identification, assessment, and mitigation was 24.05 (95% CI: 18.32, 29.77).

CONCLUSIONRisk identification, assessment, and mitigation still require further improvement in China, and both the central and local authorities should implement more effective and efficient measures.

China ; Disaster Planning ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; Risk Assessment

BACKGROUNDAt present, many administrators lack a theoretical guide to build management systems to cope with public health emergencies. This study developed a detailed function list for public health emergency management to help building the management systems scientifically.

METHODSThe five steps in this study including literature review, semistructured interviews with experts, focus group, Delphi study and focus group were conducted to develop the detailed list of functions.

RESULTSAn initial list of 25 functions with 188 items was formed through literature review. The list was reduced to 10 functions with 57 items by semistructured interviews with experts and focus group. Next, all these 57 items reached the consensus through one-round Delphi study. Some revisions of the consensus were done by the same focus group.

CONCLUSIONThe final 10 functions with 57 items could be used as a guide for most countries during their building of a public health emergency management system.

Delphi Technique ; Emergency Medical Services ; methods ; Focus Groups ; Interviews as Topic ; Models, Theoretical ; Public Health ; methods ; Review Literature as Topic

OBJECTIVETo study the efficacy of different preparations of budesonide combined with pulmonary surfactant (PS) in improving blood gas levels and preventing bronchopulmonary dysplasia (BPD) in preterm infants with neonatal respiratory distress syndrome (NRDS).

METHODSA total of 184 preterm infants who developed NRDS within 4 hours after birth were randomly administered with PS + continuous inhalation of budesonide aerosol (continuous aerosol group), PS+budesonide solution (solution group), PS + single inhalation of budesonide aerosol (single aerosol group), and PS alone, with 46 neonates in each group. The changes in arterial blood gas levels, rate of invasive mechanical ventilation after treatment, time of assisted ventilation, rate of repeated use of PS, and the incidence of BPD were compared between the four groups.

RESULTSOn the 2nd to 4th day after treatment, pH, PCO2, and oxygenation index (FiO2/PaO2) showed significant differences among the four groups, and the continuous aerosol group showed the most improvements of all indicators, followed by the solution group, single aerosol group, and PS alone group. The continuous aerosol group had a significantly shorter time of assisted ventilation than the other three groups (P<0.05). The solution group had a significantly shorter time of assisted ventilation than the single aerosol and PS alone groups (P<0.05). The rate of invasive mechanical ventilation after treatment, rate of repeated use of PS, and incidence of BPD showed significant differences among the four groups (P<0.05), and the continuous aerosol group had the lowest rates, followed by the solution group.

CONCLUSIONSA combination of PS and continuous inhalation of budesonide aerosol has a better efficacy in the treatment of NRDS than a combination of PS and budesonide solution. The difference in reducing the incidence of BDP between the two administration methods awaits further investigation with a larger sample size.

Bronchopulmonary Dysplasia ; prevention & control ; Budesonide ; administration & dosage ; Drug Therapy, Combination ; Female ; Humans ; Infant, Newborn ; Male ; Pulmonary Surfactants ; administration & dosage ; Respiration, Artificial ; Respiratory Distress Syndrome, Newborn ; drug therapy

OBJECTIVETo investigate the role of the expression of Ezh2, Runx3 and caspase-3 proteins and their correlation in the pathogenesis of endometrial carcinoma.

METHODSExpression of Ezh2, Runx3 and caspase-3 proteins was examined by tissue microarray technique and immunohistochemistry (SP method) in 72 cases of endometrial adenocarcinomas, 60 endometrial hyperplasia and 30 normal endometrial tissues.

RESULTSThe positive expression rates of Ezh2, Runx3 and caspase-3 proteins in endometrial adenocarcinomas were 83.3% (60/72), 26.4% (19/72) and 33.3% (24/72), respectively. The positive rate of Ezh2 protein in endometrial carcinomas was higher than that in normal endometrium and endometrial hyperplasia (16.7%, 33.3%, 63.3%;P < 0.05). However, the positive rate of Runx3 in endometrial carcinomas was lower than that in normal endometrium and endometrial hyperplasia (80.0%, 56.7%; P < 0.01). The positive rate of caspase-3 protein in endometrial carcinomas was lower than that in normal endometrium and endometrial hyperplasia (86.7%, 73.3%, 63.3%; P < 0.01). Positive expression of Ezh2 and Runx3 was related to the histological grade, FIGO stage, and depth of invasion of endometrial adenocarcinomas (P < 0.05), but it was not related to the lymph node metastasis (P > 0.05). Positive expression of caspase-3 protein was related to the histological grade (P < 0.05), but it was not related to the FIGO stage, depth of invasion and the lymph node metastasis of endometrial adenocarcinomas (P > 0.05). The expression of Ezh2 protein was negatively correlated to that of Runx3 (r(s) = -0.262, P < 0.05).

CONCLUSIONSAbnormal expression of Ezh2, Runx3 and caspase-3 proteins is associated with the development and progression of endometrioid adenocarcinoma. Combined analysis of Ezh2, Runx3 and caspase-3 may offer prognostic information for patients with endometrial cancer.

Adenocarcinoma ; metabolism ; pathology ; Adult ; Aged ; Caspase 3 ; metabolism ; Core Binding Factor Alpha 3 Subunit ; metabolism ; DNA-Binding Proteins ; metabolism ; Endometrial Hyperplasia ; metabolism ; pathology ; Endometrial Neoplasms ; metabolism ; pathology ; Endometrium ; metabolism ; Enhancer of Zeste Homolog 2 Protein ; Female ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Grading ; Neoplasm Invasiveness ; Neoplasm Staging ; Polycomb Repressive Complex 2 ; Transcription Factors ; metabolism

Coronary Vessel Anomalies ; diagnosis ; Electrocardiography ; Humans ; Infant ; Pulmonary Artery ; abnormalities

Objective To explore the functioning and disability and individualized rehabilitation strategies for children with cerebral pal-sy using ICF-CY. Methods ICF-CY core set for children with cerebral palsy was used, and literatures of functioning and disability (motor function) and physical activity and exercise rehabilitation for children with cerebral palsy were reviewed systematically. Based on the theo-retical framework of ICF-CY and the theories of children's development, the rehabilitation strategies for children with cerebral palsy were discussed. Results The main functioning and disability for children with cerebral palsy were impairment of brain structure and nerve system-and motor function at body level;activity limitation and participation restriction in cognition, mobility and self-care, and restriction in partic-ipation in games, leisure and educational activities at individual level and related environmental factors. The rehabilitation strategies of chil-dren with cerebral palsy should be based on the physical structure and function, activities and participation, as well as environmental factors, to develop programs that met the characteristics of the individual. Conclusion The characteristics of functioning and disability for children with cerebral palsy were analyzed using ICF-CY. Individualized rehabilitation strategies should be developed to promote the overall develop-ments for children with cerebral palsy.