Objective To observe the clinical efficacy of lung detoxification soup for treatment of patients with ventilator associated pneumonia(VAP)and its effects on serum procalcitonin(PCT),high sensitivity C reactive protein (hs-CRP)and white blood cell count(WBC). Methods A prospective randomized controlled trial was conducted, sixty cases of VAP with traditional Chinese medicine(TCM)syndrome of accumulation of phlegm and heat in lung from Department of Intensive Care Unit(ICU)in the First Affiliated Hospital of Anhui TCM University were enrolled, and the CASIO fx-360P function calculator was applied to generate random numbers to proceed to simple randomized dividing into two groups(each,30 cases). In the control group,mechanical ventilation,anti-infection,prevention of stress ulcer,early enteral nutrition,early weaning of ventilator and conventional western medicine treatment were given to the patients,while in the treatment group,based on the above conventional treatments in the control group,additionally the lung detoxification soup was given(soup composition:radix astragali 20 g ,baical skullcap root 15 g,coptis 10 g,shellfish 8 g,pinelliae tuber 10 g,white mustard seed 10 g,heartleaf houttuynia herb 15 g, honeysuckle flower 15 g,forsythia 15 g,banlangen 15 g,rhubarb 10 g,salvia miltiorrhiza 30 g)by nasal feeding, once 100 mL,twice a day. The therapeutic course was 7 days in both groups. The changes of TCM syndrome integral, levels of serum PCT,hs-CRP and WBC before and after treatment and the clinical efficacy were compared between the two groups. Results After treatment,the TCM syndrome integral,the levels of WBC,serum PCT,hs-CRP were significantly lower than those before treatment in both groups,and the decrease in treatment group being more marked〔TCM syndrome integral:4.73±1.10 vs. 10.33±1.46,WBC(×109/L):8.71±0.55 vs. 10.77±0.65,PCT (μg/L):1.64±0.40 vs. 5.71±1.25,hs-CRP(mg/L):4.96±1.06 vs. 8.85±1.53,all P<0.05〕. The total effective rate of treatment group was significantly higher than that in the control group〔(93.33%(28/30)vs. 73.33(22/30),P<0.05〕. Conclusion The lung detoxification soup can significantly improve the clinical symptoms,reduce the levels of WBC,serum PCT and hs-CRP in patients of VAP with TCM syndrome of accumulation of phlegm and heat in lung, therefore the soup may play a beneficial role as an adjuvant therapy for such patients.

Objective To examine expression of PTEN gene in ovarian cancer cisplatin-sensitive cell line OV2008 cells and cisplatin-resistant cell line C13K cells,and evaluate the effect of wild-type PTEN gene on reversing cisplatin-resistance of C13K cells and underlying mechanisms.Methods The expression of PTEN mRNA and protein in OV2008 and C13K cells were detected by semi-quantitative RT-PCR and western blot.Recombinant eukaryotic expression plasmid containing human wild-type PTEN gene was transfected into C13K cells by lipofectamine 2000.The expression of PTEN mRNA was monitored by RT- PCR and the expression of PTEN,protein kinase B(AKT),phospho-AKT(p-AKT)protein were analyzed by western blot in PTEN transfected and untransfected C13K cells.Proliferation and chemosensitivity of cells to cisplatin were measured by methyl thiazolyl tetrazolium(MTT),and cell apoptosis was detected by flow cytometry after treatment with cisplatin.Results(1)The expression of PTEN mRNA and protein(1.02 ?0.05,1.02?0.07)in OV2008 cells were significantly higher than those in C13K cells,which were 0.45 ?0.03 and 0.55?0.03 respectively(P

Objective To study the clinical application of quantitative ultrasound(QUS) which evaluate skeletal status of children and adolescents.Methods Subjects were children and adolescents aged 0-18 years old.Tibia/radial bone strength was obtained using QUS.Children who were younger than 2 years old only were measured at midpiece of tibia,and children who were older than 2 years old were measu-red at midpiece of tibia and radius.At the same time,calcium in peripheral blood was measured by the method of atomic absorption.Results 1.Radial and tibial bone strength presented nonlinear growth with age in healthy children and adolescents.2.Bone strengths of different anatomic-sites were different and the disparity rate of evaluation at different anatomic sites was 30.1%.3.The bone strength of the children who had some risk factors that could induce decrease of bone strength or had some diseases of bone metabolism was lower than healthy children.Composition of low bone strength children was 71.1% in high risk children,and was 47.9% in those who had some symptom or physical sign of calcium deficiency.4.Composition of low bone strength children was 44.2% in those who had normal peripheral blood calcium,and composition of normal bone strength children in those who had low peripheral blood calcium was 59.7%.The 2 methods had no correlation.Conclusions QUS is a quite useful technique in evaluation skeletal status of children and adolescents,and is sensitive for high risk children.It is necessary to measure radius and tibia,and consider blood calcium and bone strength to evaluate practical level of calcium and nutritional state of children.

Objective:To investigate the effect of early enteral nutrition(EEN) on nutritional state and metabolism in the critically ill patients.Methods:65 patients who had been in intensive care unit(ICU) were randomly divided into 2 groups:one group(n=35) as EEN group,another group(n=30) as parenteral nutrition(PN) group.The results of nutrition support were analysed.Results: It was found that serum albumin and hemoglobin were elevated(P0.05).Conclusion: Early enteral nutrition support has better nutritional effect in critically ill patients.

The clinical efficacy and safety of auricular acupuncture (AA) for treatment of primary insomnia was evaluated. After a comprehensive retrieval in domestic and foreign databases, literatures were strictly screened and Revman 5.2 software was applied to perform a Meta-analysis on eligible randomized controlled trials (RCTs). The evidence quality was assessed with GRADE profiler 3.6 software. As a result, 8 articles were included involving 894 patients. Compared among AA and sham AA, placebo AA, blank control, there was significant difference in Pittsburgh sleep quality index (PSQI) [WMD = -3.48, 95% CI (-3.96, -3.00)], sleep latency LWMD = -10.14, 95% CI (-17.16, -3.12)] and sleep awakening times [WMD = -9.98, 95% CI (-1.10,-0.48)]. Compared between AA and western medication, there was significant difference in PSQI [WMD = -3.62, 95% CI (-4.59, -2.65)]. The evidence quality was moderate in AA vs. sham AA, placebo AA or blank control, while that of the rest was extremely low. No reports of adverse events were described in all studies. In conclusion, for the treatment of primary insomnia, AA could effectively improve sleep quality, but due to the low evidence quality, cautious attitude should be taken on this conclusion, and clinical trials with large sample and high quality were needed in the further.
Acupuncture, Ear ; Humans ; Randomized Controlled Trials as Topic ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy

Sodium houttuyfonate (SH) is a derivative of effective component of a Chinese material medica, Houttuynia cordata, which is applied in anti-infection of microorganism. But, the antimicrobial mechanisms of SH still remain unclear. Here, we firstly discovered that SH effectively inhibits the three types of virulence related motility of.Pseudomonas aeruginosa, i.e., swimming, twitching and swarming. The plate assay results showed that the inhibitory action of SH against swimming and twitching in 24 h and swarming in 48 h is dose-dependent; and bacteria nearly lost all of the motile activities under the concentration of 1 x minimum inhibitory concentration (MIC) (512 mg x L(-1) same as azithromycin positive group (1 x MIC, 16 mg x L(-1)). Furthermore, we found that the expression of structural gene flgB and pilG is down-regulated by SH, which implies that inhibitory mechanism of SH against motility of P. aeruginosa may be due to the inhibition of flagella and pili bioformation of P. aeruginosa by SR Therefore, our presented results firstly demonstrate that SH effectively inhibits the motility activities of P. aeruginosa, and suggest that SH could be a promising antipseudomonas agents in clinic.
Alkanes ; pharmacology ; Anti-Bacterial Agents ; pharmacology ; Bacterial Proteins ; genetics ; metabolism ; Biofilms ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Fimbriae, Bacterial ; drug effects ; genetics ; metabolism ; Houttuynia ; chemistry ; Pseudomonas aeruginosa ; cytology ; drug effects ; genetics ; pathogenicity ; Sulfites ; pharmacology ; Virulence ; drug effects

Objective To observe the influence of longmuzhuanggu powder(LMZGP)on gastroenteric movement and plasm motilin(MTL)in rats.Methods Rats were randomly divided into control group,model group,LMZGP large dose group,LMZGP middle dose group,and LMZGP low dose group.To establish the model of disorder of gastric depletion and small intestinal advancement by using maxolon,atropine,neostigmine and adrenaline.Gastric emptying and intestinal progradating rates in mice were tested with black nutritious semi solid cataplasm.Level of MTL in hemtatoplasma was tested by radio immunoassay.Results Maxolon accelerated gastric depletion and neostigmine accelerated intestine propagation and heightened the level of MTL in hematoplasma(P_a

Objective To explore the effect of in utero exposure to inlfammation on innate immune response in preterm infants. Methods Forty-seven premature infants with gestational age<35 weeks were recruited in this study. According to his-tological evidence of placental infection, all neonates were divided into intrauterine inlfammation positive group and negative group. Mononuclear cells and monocytes were isolated from umbilical cord blood, and were cultured in vitro in the presence or absence of LPS (100 ng/ml). The levels of interleukin 1β(IL-1β), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α) and interleukin 10 (IL-10) in cord blood plasma and monocyte cultural supernatants were measured by ELISA respectively. The level of IL-1β, TNF-α, IL-6 and IL-10 mRNA were detected by Real-time PCR. Expression of HLA-DR on surface of CD14+monocytes and ratio of CD3+CD4+/CD3+CD8+T was analyzed by lfow cytometry. Results (1) The level of cord plasma IL-6 in intrauterine inlfammation positive group was signiifcantly higher than in negative group. (P=0.02). (2) After stimulation of LPS, levels of IL-1β, IL-6, TNF-α, IL-10 in supernatants were increased signiifcantly, in consistence with their mRNA expression (P<0.05) in both groups. (3) Expression of HLA-DR on surface of monocytes was signiifcantly decreased after stimulation with LPS in intrauterine inlfammation positive group (P=0.012), but was signiifcantly increased in negative group (P=0.0305). Con-clusions In utero exposure to inlfammation does not suppress the response of monocytes to LPS in preterm neonates, but impairs the antigen presenting function in monocytes.

Objective To prepare lipid-coated ultrasound microbubbles containing 10-HCPT(HLM) and explore the antitumor effects on mice xenografed H22 solid tumor using the technique of ultrasound-mediated HLM destruction. Methods Sixty-four tumor-bearing mice were radomly divided into A and B groups. Each group was divided into four groups again and administered respectively by tail vein with HI.M, non-drug-loaded microbubbles,10-HCPT and saline once a day. Ultrasound irradiation was applied on the tumor sites immediately after injection. After 7 days of consecutive treatment, all mice in group A were sacrificed and the tumors were harvested to measure weights. The tumor inhibition rate was calculated by weights. The tumor microvessel density (MVD) was detected by immunohistochemical staining. The tumor growth curve was depicted according to volumes. The survival time of mice in group B was recorded. Results The tumor inhibition rate was the highest in HLM group while this group's MVD was the lowest. Survival time in HLM group and 10-HCPT group were obviously longer compared with the control group,while no statistic difference was observed between the two groups. There was no statistic difference between the group of non-drug-loaded microbubbles and the control group. Conclusions Ultrasound irradiation mediates HLM destruction so that the drug is released from the vihicles at the same time, which can significantly enhance the tumor inhibition effect of 10-HCPT on the H22 tumor. This technique is expected to be adopted as a novel tool for liver cancer chemotherapy.

Objective To study the impact of the off-pump coronary artery bypass compared to the on-pump coronary artery bypass technique on the rate of acute kidney injury.Methods A retrospective analysis of 824 patients accepted coronary artery bypass surgery in FuWai Hospital Surgical ICU from March 2011 to January 2013.Patients were divided into two groups according to the surgical approach,597 patients in on-pump group and 227 patients in off-pump group.Then compared the difference of acute kidney injury incidence in the two groups.Results 92 patients in the on-pump group occurred AKI,the incidence of AKI was 15.4％.32 patients in the off-pump group occurred AKI,the incidence of AKI was 14.1％.Two groups of patients had no statistical difference in the incidence of AKI,x2 =0.222,P =0.638.Based on the preoperative baseline creatinine clearance levels.We defined normal creatinine clearance (SCR ≥ 60 ml/min),mild renal insufficiency (45 ml/min ＜ SCR ＜60 ml/min),moderate renal dysfunction group(31 ml/min ＜ SCR ＜45 ml/min).Decline with the preoperative creatinine clearance rate,the AKI incidence was elevated significantly,P ＜0.05.Patients with moderate renal insufficiency,offpump patients had lower incidence of AKI than those in on-pump group,P ＜ 0.05.The incidence of renal replacement in the two group patients had no statistical differences.Conclusion The incidence of AKI after coronary artery bypass surgery had no statistical differences with or without pump.In the patients with preoperative moderate renal insufficiency,off-pump can reduce the incidence of AKI,but could not change the kidney the incidence of renal replacement treatment.