Objective To investigate effects of different sedation methods on the mechanical ventilation patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 101 patients with mechanical ventilation in our hospital was randomly divided into observation (58 cases) and control (43 cases) groups.The observation group was given to strengthen psychological care during the day, and the night was given to the patients with AECOPD.The control group was treated with continuous analgesia and sedation, and the daily morning was executed to wake up the plan 1 ～ 2 hours.A set of indexes were observed, including white cell count, C-reactive protein, oxygen index, B-type natriuretic peptide, delirium occurred rate, unexpectedly drawn tube rate, and duration of mechanical ventilation.Results White blood cell number, C reactive protein, and oxygen index group in the observation group were significantly better than the control group [(10.1 ± 2.4) × 109/L vs (11.2 ± 2.8) × 109/L,(40.6 ± 11.6) mg/L vs (45.8 ± 12.2) mg/L, and (285.6 ±45.1) vs (268.2 ±42.6)] (P ＜0.05).The incidence of delirium rate in the observation group was significantly lower than the control group [30/58(51.7％) vs 31/43(72.1％)] (P ＜0.05).The mechanical ventilation time in the observation group was significantly shorter than the control group [(8.41 ± 3.96) d vs (10.35 ± 5.57) d] (P ＜ 0.05).There was no significant difference between B type natriuretic peptide and accidental extubation rate (P ＞ 0.05).Conclusions The night program sedation program can significantly improve AECOPD mechanical ventilation in patients with inflammatory index and oxygen index, reduces the incidence of delirium in patients with acute exacerbation of chronic obstructive pulmonary disease, does not increase the accidental extubation rate, and significantly shortens the AECOPD patients with mechanical ventilation duration of mechanical ventilation, as a mechanical ventilation in AECOPD patients who killed one of the options.

BALB/c mice were immunized with purified White spot syndrome virus (WSSV).Six monoclonal antibody cell lines were selected by ELISA with VP28 protein expressed in E.coll in vitro neutralization experiments showed that 4 of them could inhibit the virus infection in crayfish.Westernblot suggested that all these monoclonal antibodies were against the conformational structure of VP28.The monoclonal antibody 7B4 was labeled with colloidal gold particles and used to locate the VP28 on virus envelope by immunogold labeling.These monoclonal antibodies could be used to develop immunological diagnosis methods for WSSV infection.

OBJECTIVE The eradication of cancer stem cells(CSCs)is signifcant for cancer therapy and prevention.METHODS In this study,we evaluated WM130,a novel derivative of matrine,for its effect on CSCs using human hepatocellular carcinoma(HCC)cell lines,their sphere cells,and sorted EpCAM+cells. RESULTS We revealed that WM130 could not only inhibit proliferation and colony formation of HCC cells, but also suppress the expression of some stemness-related genes and up-regulate some mature hepatocyte marker genes, indicating a promotion of differentiation from CSCs to hepatocytes. WM130 also suppressed the proliferation of doxorubicin-resistant hepatoma cells, and markedly reduced the cells with CSC biomarker EpCAM.Moreover,WM130 suppressed HCC spheres,not only primary spheres but also subsequent spheres,indicating an inhibitory effect on self-renewal capability of CSCs.Interestingly,WM130 exhibiteda remarkable inhibitory preference on HCC spheres and EpCAM+cells rather than their parental HCC cells and EpCAM- cells respectively. In vivo, WM130 inhibited HCC xenograft growth, decreased the number of sphere-forming cells, and remarkably decreased the levels of EpCAM mRNA and protein in tumor xenografts. Better inhibitory effect was achieved by WM130 in combination with doxorubicin.Further mechanism study revealed that WM130 inhibited AKT/GSK3β/β-catenin signaling pathway. CONCLUSION Collectively, our results suggest that WM130 remark-ably inhibits hepatic CSCs, and this effect may via the down-regulation of the AKT/GSK3β/β-catenin pathway.These findings provide a strong rationale for the use of WM130 as a novel drug candidate in HCC therapy.

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.

Objective To investigate the short-term efficacy of antiviral therapy in acute-on-chronic liver failure associated with hepatitis B.Methods A total of 348 patients with acute-on-chronic liver failure associated with hepatitis B,of which 173cases of low viral load(HBV DNA<105copise/ml)and 175 cages of high viral load (HBV DNA≥105copies/ml),were divided into two groups.One was treated with antiviral therapy(LAM or ETV or Ltd)and routine supportive therapy,and the other received supportive therapy only.The clinical features,survival rate and the short-term efficacy of antiviral therapy were compared between the two.Results It sas indicated in Cox regression analysis of multiple factors that antiviral therapy is the favorable factor of affecting pmgnosis.The survival rate of the group receiving antiviral therapy was higer than that of the one in control group in a 24-week observation.In patients with 4 weeks treatment there were statistical significant differences(P≤0.05)in beth the Ievd of TBil in serum and the decreasing amplitude of HBV DNA between the two groups.Also after 24-week therapy the survival rates of the patients with both low and high viral load was higer in the group with antiviral therapy,and that made statistically significant(P≤0.05).Conclusion Antiviral therapy can improve the survival rate of the acute-on-chronic liver failure associated with hepatitis B.And it is also needed in patients with low viral load.

OBJECTIVETo explore the clinical efficacy of open-door cervical laminoplasty combined Modified Buyang Huanwu Decoction (MBHD) to treat cervical spinal canal stenosis (CSCS).

METHODSTotally 32 CSCS patients were randomly assigned to two groups, Group A (17 cases, treated by laminoplasty) and Group B (15 cases, treated by laminoplasty combined MBHD). All patients received open-door cervical laminoplasty. Those in Group B took MBHD additionally for 2 weeks after surgery. The visual analogue scale (VAS), the Japanese Orthopedic Association (JOA) score, and the neck disability index (NDI) were measured preoperative, postoperative 3 months and 12 months, respectively.

RESULTSThere was no statistical difference in preoperative VAS, JOA, or NDI (P > 0.05). The VAS, JOA, and NDI were obviously improved 3 months and 12 months after surgery in the two groups, showing statistical difference when compared with before surgery in the same group (P < 0.01). At 3 months after surgery the aforesaid indices in Group B were superior to those in Group A (P < 0.05). There was no statistical difference in the aforesaid indices between the two groups at 12 months after surgery (P > 0.05).

CONCLUSIONMBHD favorably improved early recovery of neural functions of CSCS patients (3 months after surgery).

Adult ; Aged ; Cervical Vertebrae ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Phytotherapy ; Spinal Stenosis ; therapy ; Treatment Outcome

OBJECTIVE: To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR). METHODS: Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives. All patients were given persistent external compression, airway open, tube intubation, and mechanical ventilation, vasoactive drugs application, defibrillation if required. STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines. On the basis of the standard CPR, IAPP-CPR group was recovered using abdominal lifting and compressing CPR instrument to press down to lift the upper abdomen continuously, when the chest compressing relaxed (frequency 100 times/min, down and lift time ratio 1:1, compressing strength 50 kg, lifting strength 30 kg). The patients' gender, age and CA etiology were recorded in the two groups. The vital signs and blood flow of carotid artery were monitored with ultrasonic Doppler during the CPR. The return of spontaneous circulation (ROSC) rate and 48-hour survival rate were observed in patients. The influence factors of ROSC were screened by Logistic regression analysis. RESULTS: The data of 75 patients with CA were enrolled finally, with STD-CPR group of 38 patients and IAPP-CPR group of 37 patients. There were no significant differences in patients' gender, age or CA etiology between the two groups. Comparing with STD-CPR group, the peak blood flow velocity of carotid artery in IAPP-CPR group was speeded up significantly (cm/s: 107.16±13.75 vs. 78.99±14.77, P < 0.01), the overall blood flow volume of carotid artery was increased significantly (mL/min: 989.06±115.88 vs. 751.62±118.92, P < 0.01), but there was no significant difference in inner diameter of carotid artery between the two groups (mm: 4.55±0.25 vs. 4.61±0.21, P > 0.05). During the CPR, the mean arterial pressure (MAP) and the transcutaneous oxygen saturation (SpO₂) in IAPP-CPR group were significantly higher than those of STD-CPR group, but no significant difference was found in heart rate between the two groups. Four patients in STD-CPR group got ROSC, and 3 survived over 48 hours (1 myocardial infarction patient died of ventricular fibrillation) while 6 patients in IAPP-CPR group got ROSC and survived over 48 hours. There was no significant difference in ROSC rate or 48-hour survival rate between the two groups, but data of IAPP-CPR group was slightly higher than that of STD-CPR group [ROSC rate: 16.22% (6/37) vs. 10.53% (4/38), 48-hour survival rate: 16.22% (6/37) vs. 7.89% (3/38), both P > 0.05]. Multivariate Logistic regression analysis showed that the higher the MAP during CPR, the greater the possibility of ROSC was [odds ratio (OR) = 1.361, 95% confidence interval (95%CI) = 1.182-1.669, P = 0.030]. CONCLUSIONS IAPP-CPR was superior to traditional STD-CPR in improving arterial blood flow and resuscitation effect, but no superiority was found in ROSC rate and survival rate, which may be relate to the small number of patients that included in this study. More clinic trials are needed.
Cardiopulmonary Resuscitation ; Electric Countershock ; Heart Arrest ; Humans ; Ultrasonics ; Ventricular Fibrillation

Objective To study the clinical and pathological characteristics,diagnoses and treatments of nonfunctioning parathyroid cysts. Methods Six cases of nonfunctioning parathyroid cysts treated in Tongren Hospital during 2002-2009 were retrospectively analyzed.Nonfunctioning parathyroid cysts in the six patients were inadvertently found as neck masses by physical examination.The levels of serum calcium,phosphorus and parathyroid hormone were normal.Five cases of 6 patients with imaging suggested the existence of cystic mass in the back of inferior thyroid in 5 cases of the 6 patients.Results Tumors in the 6 patients were removed surgically and diagnosed as parathyroid cysts with post-operative pathological examination. PTH ( parathyroid hormone ),CgA ( chromogranin A ),Syn ( synaptophysin )expressions in the tumors were positive. No recurrence was found with follow-up of 2-9 years after operation.Conclusions Surgical resection is most effective for the treatments of nonfunctioning parathyroid cysts and pathologic examination is required for the determined diagnosis of this disease. Fine needle asniration can be helpful for the diagnosis before operation.

OBJECTIVESTo discuss the methods and outcome of shorting proximal femoral and total hip arthroplasty for Crowe IV dysplastic hip of adults.

METHODSFrom July 2000 to February 2006, 13 cases of osteoarthritis secondary to severe development dysplastic hip were treated by total hip replacement and the shorting proximal femoral.

RESULTSThe duration of follow-up ranged from 4 months to 55 months. The average score increased from 36.9 to 84.1 points after the surgery according to Harris. All the patients could walk independently. Their paces were improved obviously and the function of their hips was satisfactory.

CONCLUSIONSThe treatment by total hip arthroplasty and the shorting of posterior femoral is effective and efficient for osteoarthritis secondary to Crowe IV development dysplastic hip in adults. The long-term followup is necessary for further study.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femur ; surgery ; Follow-Up Studies ; Hip Dislocation ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Osteotomy ; methods ; Retrospective Studies ; Treatment Outcome