Objective:To evaluate the clinical efficacy of Suhuang Zhike capsules combined with montelukast in the treatment of cough caused by upper respiratory infection. Methods:Totally 120 patients with cough after upper respiratory infection were randomly divided into the treatment group (64 cases) and the control group (56 cases) by the random number table. The control group received Montelukast chewable tablets alone(10 mg,po qn), while the treatment group received Suhaung Zhike capsules(1. 35 g,po,tid) com-bined with Montelukast chewable tablets. The treatment course was 2 weeks, and the efficacy and adverse reactions between the two groups after the treatment were compared. Results:The significant efficiency and the total efficiency of the observation group were sig-nificantly highter than those of the control group, and the difference was statistically significant(P<0. 05). After the treatment, the cough symptom score and the expectoration symptom score of the two groups were decreased significantly than those before the treatment (P<0.05), both scores of the observation group were significantly lower than those of the control group after the treatment(P >0. 05). The incidence of adverse reactions of the two groups had no significant differencet(P<0. 05). Conclusion: As for the clinic efficacy, the combination of Suhaung Zhike capsules and Montelukast is significantly better than Montelukast therapy, and the combina-tion is an effective and safe treatment for cough after upper respiratory infection and worthy of promotion in clinical practice.

Objective To investigate the preventive effect of post abortion care(PAC) on unsafe sexual behaviors and deficiency in the knowledge of unmarried females,especially the youth in order to prevent repeated.unintended pregnancies as well as to promote the unmarried female's reproductive health.Methods During the period from Jan.2012 to Jun.2013,171 unmarried young women (＜ 24 years old) were enrolled in the study who were underwent free willed induced abortion due to unwanted pregnancy in Maternal and Child Health-Care Hospital of Huangpu District of Shanghai.Their reproductive health related knowledge,attitude and behavior were investigated by questionnaires.Based on the information above,they were provided with a series of post abortion services and improvement of reproductive health cognition and prevention effect of repeat pregnancy were evaluated after the intervention.Results After the nosocomial PAC intervention,the research objects are improved in the contraceptive knowledge and contraceptive behavior largely than before.The awareness rate on the female fertile time was increased from 53.8％ (92/171) to 80.6％ (137/170).The common contraceptive awareness rate increased from 49.1％ (84/171) to 91.8％ (156/170).The difference was statistically significant (x2 =27.30,x2 =75.69,P ＜ 0.05).After 1 year follow-up,the PAC intervention make in contraceptive behavior change.The contraception rate increased from 8.2％ (14/171) to 65.3％ (111/170).The contraceptive failure rate was reduced from 35.7％ (61/171) to 4.7％ (8/170) (x2 =165.24,36.12,P ＜ 0.05).There was not complications occurrence.Conclusion PAC can improve the contraception rate and reduce the unmarried female youth repeated abortion rate effectively.

Objective To investigate the safety,therapy and prophylactic effect of Omeprazole on stress ulcer in children with epidemic type B encephalitis.Methods Before and after medication,chest X-ray examination was performed.The result of occult blood(OB) was confirm by Colloidal gold assay in stool and/or gastric juice.Based on the result of OB,the patients were divided into therapy group[besides conventional therapy for encephalitis,Cimitidine group and Omeprazole group with positive result OB,was administered with 0.9% normal sodium 100 mL+Cimitidine 20-40 mg/(kg?d),iv,q12 h and normal sodium 100 mL+Omeprazol 0.5-0.8 mg/(kg?d),iv,qd,respectively] and prophylaxis group(Cimitidine group,Omeprazole group and control group,with negative result OB,were administered with same medicines as therapy group,respectively.Except control group being administered only 0.9%NS 100 mL,iv,(q12 h)).The effects of drugs on hemostasis,preventing hemorrhage,and the potential risk of acquired pneumonia result from drugs used were observed.Results In therapy group,the average time of hemostasis in Omeprazole group was obviously shorter than that of in Cimitidine group,there was significant difference between two groups(P0.05).Conclusions Both of the drugs is safety and effect to therapy or prophylaxis for the latent stress ulcer in short term.The effect of Omeprazole is better than those of Cimitidine.Using Cimitidine and Omeprazole,neither therapy nor prophylaxis for stress ulcer increaseds the potential risk of acquired pneumonia in children with epidemic type B encephalitis in this study.

Apolipoproteins A ; therapeutic use ; Coronary Disease ; drug therapy ; prevention & control ; Humans ; Recombinant Proteins ; therapeutic use

Objective To investigate the rationality and prognostic value of the Criteria for clinical staging of esophageal cancer treated by non-surgical methods (Draft) by comparison with the criteria for postoperative pathological staging.Methods A retrospective analysis was performed on the clinical data of 162 patients with esophageal cancer who underwent radical resection at the Second Hospital of Soochow University from December 2008 to July 2012.Preoperative clinical staging and postoperative pathological staging were performed,and the Kappa statistic was used to evaluate the agreement between the two staging systems.The Kaplan-Meier method was used to calculate overall survival (OS) rates,and the log-rank test was used for survival difference analysis and univariate analysis.Results The coincidence rates of T,N,and TNM stages were 67.9％,57.4％,and 67.9％,respectively,and the agreements were moderate,poor,and moderate,with Kappa values of 0.544,0.302,and 0.509.The follow-up rate was 93.2％.The 1-,2-,and 3-year sample sizes were 127,66 and 27,respectively.The 1-,2-,and 3-year OS rates were 82.6％,56.2％,and 37.7％,respectively.There were no significant differences in OS between patients with preoperative T1 and T2 stages and between patients with preoperative N0 and N1 stages (P =0.086,0.101),but significant differences were observed between patients with different T stages,N stages,or TNM stages (P =0.000-0.028).This was in line with the prognostic results based on the postoperative pathological staging.Conclusions The clinical staging criteria (draft) have moderate agreement with the criteria for postoperative pathological staging and have good prognostic value,but they require further refinement and improvement.

Objective To evaluate the accuracy of stoke volume variation (SVV) determined using FloTrac/Vigileo and Picco-plus technologies in prone position for assessment of the blood volume in the patients undergoing spine surgery,Methods Forty-three ASA physical status Ⅰ-Ⅲ patients of both sexes,aged ＞ 18 yr,weighing 40-100 kg,scheduled for elective posterior approach to lumbar spinal fusion or scoliosis surgery were studied.After induction of anesthesia,a volume expansion was performed in supine and prone positions.Hydroxyethyl starch 130/0.4 sodium chloride injection 5 ml/kg was rapidly infused intravenously over 10 min to carry out the test for fluid responsiveness.Picco-plus and FloTrac/Vigileo systems were simultaneously applied in every subject to measure SVV (SVVP and SVVF).Positive fluid responsiveness was defined as the changing rate of stroke volume index ≥ 10％ as measured by using Piccoplus system.The patients were divided into response group (Rs group) and non-response group (NRs group) according to the changing rate of stroke volume index ≥ 10％ and ＜ 10％.The receiver operating characteristic (ROC) curve for SVV was plotted,and the diagnostic threshold,area under the ROC curve and 95％ confidence interval (CI) were calculated.Results Forty-one patients were included for analysis in this study.In supine position,the area under the ROC curve for SVV in predicting the fluid responsiveness was 0.740 (95％ CI:0.568-0.913),the diagnostic threshold was 12％,and the sensitivity and specificity in determining fluid responsiveness were 86％ and 54％,respectively,for SVVF,and the area under the ROC curve was 0.637 for SVVP.In prone position,the area under the ROC curve was 0.451 for SVVF,and 0.634 for SVVP.Compared with Rs group,the baseline value of SVVFwas significantly lower,and no significant change was found in the other hemodynamic parameters before volume expansion in supine position in NRs group.There was no significant difference in the hemodynamic parameters before volume expansion in prone position between the two groups.Conclusion SVV determined by using FloTrac/Vigileo and Picco-plus systems in prone position can not accurately assess the blood volume in the patients undergoing spine surgery.

Objective To investigate the change of peripheral blood CD4+CD25+ regulatory T cells (Tr) in patients with idiopathic thrombocytopenic purpura (ITP), and to analyze its role in the pathogenesis of ITP.Methods Anticoagulated venous blood was collected from ITP patients (ITP group,n=35) and healthy controls (healthy control group,n=35). T lymphocytes were isolated and purified with human CD3+ T cell enrichment columm. The percentage of peripheral blood CD4+CD25+ regulatory T cells was detected by immunofluorescence staining (PE-anti-CD4 monoclone antibody and FITC-CD25 monoclone antibody) and bicolor flow cytometry by CD25/CD4 gating.Results The number and constituent ratio of CD4+CD25+T cell were significantly lower in ITP group than those of healthy control group (P<0.05).Conclusion There is peripheral blood celluar immunological function disorder in ITP patients, and decrease of CD4+CD25+ T cell population may be involved in the pathogenesis of ITP.

Objective To investigate the protective effect of desflurane preconditioning on human umbilical vein endothelial cells against anoxia-reoxygenation(A/R)injury.Methods The human umbilical vein endothelial cell line(ECV304)was provided by the Liver Cancer Institute,Zhongshan Hospital,Fudan University.ECV304 cells were randomly divided into 5 groups:group Ⅰ normal control;group Ⅱ A/R;group Ⅲ A/R+rhTNF-α;group Ⅳ Des + A/R and group Ⅴ Des + A/R + rhTNF-α.In group Ⅱ-Ⅴ the cells were exposed to 95% N2 + 5% CO2 in an incubator for 30 min followed by 60 min reoxygenation.In group Ⅲ and Ⅴ rhTNF-α(10 ng/ml)10 μl was added to the cells as soon as reoxygenation was started,while in group Ⅳ and Ⅴ the cells were pretreated with 7.2% desflurane for 30 min followed by 10 min washout before A/R.Apoptosis in endothelial cells was detected by fluorescence flow cytometry and TUNEL.Endothelial cells were examined with electron microscope for apoptosis and necrosis.Results The rates of apoptosis in the endothelial cells were significantly higher in A/R group and A/R + rhTNF-α group than in control group.Desflurane preconditioning significantly attenuated apoptosis in the endothelial cells induced by A/R and A/R + rhTNF-α respectively.Electron microscopy showed that there were significantly more necrotic cells in A/R group and A/R + rhTNF-α group.However in the two desflurane preconditioning groups(Ⅳ and Ⅴ)the cells were in a state of duplication and self-repairing.Conclusion Preconditioning with 30 min 7.2% desflurane can attenuate the A/R-induced injury to human umbilical vein endothelial cells.

Objective To investigate the changes of cognitive function after major non-cardiac surgery and the relationship between the postoperative cognitive dysfunction(POCD)and the intraoperative cerebral oxygen metabolism in the elderly.Methods Sixty-four patients(49 male,12 female)aged 65-85 yr undergoing elective major non-cardiac surgery were enrolled in this study.A battery of four neuropsycbological tests was administered 2-3 days before and 7 days after surgery by an experienced psychometrician.A postoperative deficit in any test was defined as a cognitive decline by more than or equal to the preoperative standard deviation of that test in all patients.As long aft any patient showed cognitive decline in two or more tests.this situation was defined as POCD.Blood samples were taken from radial artery and internal jugIIlar vein simultaneously for blood gas analysis immediately (T1) and 2 h (T2) after induction of anesthesia,and just before leaving postanesthesia care unit (T3).The ratio of cerebral blood flow to cerebral oxygen metabolic rate(CBF.CMR02)was calculated.Results Sixty-one patients completed postoperative neuropsychological tests and 10 cases(16.4%)had POCD.Logistic regression analysis showed that the abnormality of CBF/CMR02 during operation was associated with the occurrence of POCD.Conclusion The occurrence of POCD after major non-cardiac surgery is related to the abnormality of cerebral oxygen metabolism during operation.

Objective To observe the efficacy of invasive ventilation (Ⅳ) in treatment of acute pulmonary edema (APE), and to explore the factors associated with prognosis. Method From March 2005 to December 2007, 23 APE patients, who were hospitalized in the EICU of People' s Hospital of Peking University and the con-ventional treatment and noninvasive ventilation were not effective, were treated by Ⅳ (PEEP 5～18 cmH2O). Blood pressure, heart rate, respiratory rate, and arterial blood gas values were recorded accurately before and after ventilation and compared with each other. Regression analysis was used to analyze the factors associated with prog-nosis. Resets Three hours after Ⅳ, the blood pressure, heart rate, respiratory rate, arterial blood gas were sig-nificanfly improved (P <0.01). Among the 23 patients, 11 survived, and the other 12 patients died. Nine pa-tients died of MOF. Among 16 patients with cardiac function Ⅲ-Ⅳ, 10 died. Among 15 patients with acute my-ocardial infarction, 9 died. Among 11 patients with renal insufficiency, 9 died. The multivariate logistic regression analysis showed that the reduced left ventricular ejection fraction, the lower mean arterial pressure, and the in-creased creatinine were the independent predictor of prognosis. Conclusions Invasive ventilation is an effective method of treating patients with acute pulmonary edema. Proper ventilation may improve the cardiac function and clinical symptoms, but it's not the fundamental measure for increasing cure rate. 1he renal insufficiency and heart failure are the independent predictor of prognosis.