Objective:To explore the relevance of a new comprehensive respiratory mechanics parameter, elastic power, to the 28-day prognosis of ARDS patients.Methods:Patients with ARDS hospitalized for at least 48 h with invasive mechanical ventilation in five intensive care units in three local hospitals in Lianyungang City from June 2018 to June 2022 were included in the study. Their baseline data and respiratory mechanics parameters were collected. Elastic power, mechanical power, driving pressure and lung compliance are calculated according to the corresponding formulae. The prognostic risk factors of ARDS patients were analysed using COX multi-factor regression, and the predictive value of EP/Cst on the 28-day prognosis of ARDS patients was evaluated based on ROC curve analysis and Kaplan-Meier survival curve.Results:There was no significantly difference in tidal volume and PEEP settings between the patients in the ARDS survivor and death groups ( P> 0.05). However, the differences in respiratory rate, plateau pressure, driving pressure, lung compliance, mechanical work, elastic work, EP/cst and MP/cst between the two groups were significantly different (all P< 0.01). Multifactorial COX regression analysis showed that EP/cst ( HR=1.211, 95% CI:1.091-1.323) and RR ( HR=1.209, 95% CI:1.046-1.339) were strongly associated with a more severe degree of illness and a worse prognosis in ARDS. And the cumulative survival rate at 28 d was significantly lower in the high Cst-EP group than in the low Cst-EP group (50.00% vs. 82.40%, P < 0.01). Conclusions:The new respiratory mechanics parameters EP and EP/Cst can assess the severity of ARDS with a good predictive effect on patient prognosis at 28 days.

Objective:To develop a list of basic and expanded medical laboratory tests in community health service centers in Shanghai.Methods:The status quo of human and equipment resource allocation, the test items and quality control currently performed, the perspectives of various stakeholders, the capacity building of community clinical laboratory in community health service centers in Shanghai were investigated by quantitative survey and qualitative interview; and the rating scores of each test item were assessed by expert consultation using Delphi method. The expert focus discussion was conducted, and each test item was rated and classified. Finally a list of the basic tests and expanded tests in clinical laboratories of community health service center was developed.Results:A total of 247 questionnaires were distributed and 192 (77.7%) were answered. A list of 94 laboratory test items was screened out based on the questionnaire survey of the laboratories of the community health centers. Thirty one experts in the relevant areas were invited to rate the test items, the average authority coefficient of experts was 0.90, with which the weighted average of the expert ratings was made. There were 45 (47.9%) items scored 7 or higher, 38 (40.4%) scored between 5 and 7, and 11 (11.7%) scored less than 5. Based on the results of the expert focus discussion, 48 items were recommended as the basic tests and 46 items as the extended tests.Conclusion:In this study a list of tests recommended to clinical laboratories in Shanghai community health service centers has been developed, which contains 48 basic tests and 46 extended tests.

Objective To investigate the distribution and antimicrobial resistance profile of the common pathogens isolated during the period from 2009 to 2015.Methods All the bacterial strains isolated from pediatric inpatients in Beijing Children's Hospital during the period from 2009 to 2015 were analyzed. Antimicrobial susceptibility was determined by disk diffusion method and Phoenix 100 Automated Microbiology System. Results were analyzed according to the guidelines of CLSI (2014) using WHONET 5.6 software.Results The total strains were 26630. The most common gram-positive isolates were Streptococcus pneumoniae,Staphylococcusaureusand coagulase-negative Staphylococcus (CNS), while the most frequently isolated gram-negative microorganisms were Klebsiella spp.,Pseudomonas aeruginosa and Escherichia coli. The prevalence of S. pneumoniae was up to 25.7 % (4101/15973) in all respiratory tract specimens. About 50.2 % of the S. pneumoniae isolates were not susceptible to penicillin. The prevalence of methicillin-resistant strains was 20.6 % in S. aureus (MRSA) and 87.8 % in coagulase negative Staphylococcus (MRCNS) on average. The prevalence of MRSA increased from 11.1 % in 2009 to 29.8 % in 2015. No S. pneumoniae or staphylococcal strains were found resistant to vancomycin or linezolid. The Enterococcus strains were still highly susceptible to vancomycin and linezolid. Overall 0.3 % of the Enterococcus faecium isolates were resistant to vancomycin. The extended-spectrum beta-lactamases (ESBLs) producing strains accounted for 71.4 % -78.1 % of E. coli and 65.1 % - 76.9 % of K. pneumoniae isolates. The carbapenem-resistant E. coli and K. pneumoniae were reported for the first time in 2010, but in 2014, the strains resistant to carbapenems had increased to more than 7 % in E. coli, and higher than 20 % in K. pneumoniae. In 2015, up to 27.7 % and 25.7 % of P. aeruginosa isolates were resistant to imipenem and meropenem, respectively, and 59.9 % of the A. baumannii isolates were resistant to imipenem and meropenem. Beta-lactamase was positive in 46.3 % of the H. influenzae isolates. Conclusions MRSA and the carbapenem-resistant strains of E. coli,K. pneumoniae and A. baumannii are still on the rise in pediatric inpatients, which poses a serious threat to clinical practice and implies the importance of strengthening infection control.

Objective To prepare long-circulating temperature-sensitive liposomes with paclitaxel( LTSLP ),develop methods for determination of paclitaxel,related substances and monostearoyl phosphatidylcholine( MSPC ) in LTSLP,and the haemolysis of LTSLP in vitro. Methods HPLC-UV methods for paclitaxel content and related substances and HPLC-CAD method for MSPC in LTSLP were established and validated. Spectrophotometric method was used to determine hemolysis in vitro. Results There was a good linear relationship between peak area and concentration within the range of 60. 39-181. 17μg·mL-1 . Recovery and precision of the method for determination of paclitaxel content met the requirements. Specificity,sensitivity,and system suitability for related substances were consistent with requirements. There was a good linear relationship between peak area and concentration within the range of 1. 5-50. 0μg·mL-1 for the determination of MSPC with good specificity,sensitivity and recovery. Paclitaxel contents in three batches of self-prepared LTSLP were between 90. 0% and 110. 0%,single related substances were below 0. 5% and total impurities were below 2. 0%. There was almost no hemolysis in vitro. Conclusion The methods for determining paclitaxel content,related substances and haemolysis can be used to assess the quality of LTSLP. Self-produced LTSLP consistently meet the quality standards.

Objective To observe the effects and characteristics of vestibular illusions and vestibular autonomic reactions induced by short arm centrifuge exposure,and to search the appropriate rotation speed of short arm centrifuge for vestibular illusion simulation training on the ground.Methods Ninety healthy pilots were divided into 3 groups by the rotation speed of 21,30 and 37 r/min that generated by SAC-Ⅲ short arm centrifuge.By referencing the vestibular illusions simulation training on electric rotating chair,they were exposure to the simulation of counter-rotatory illusion and Coriolis illusion.Vestibular illusions and vestibular autonomic reactions were compared.Results ①When the speed was 21 r/min,the induced rates of the counter-rotatory illusion,Coriolis tumbling illusion (including head turn to right and to left) and Coriolis somatogyral illusion (including head pitched up and down) were lower than the induced rates under the speed of 30 r/min and 37 r/min (X2＝6.477 20.000,P＜0.01 or P＜0.05).And when the speed was 30 r/min and 37 r/min,the induced rates showed no significant difference (x2 ＝0.073-0.351,P＞0.05).②The expressions and characteristics of the centrifuge evoked counter-rotatory illusion were approximately the same under three different rotation speeds,while the illusion strength was enhanced with the speed increase.The expressions and characteristics of the Coriolis tumbling illusion induced by different speed showed no significant difference (X2 ＝0.090,0.056,P＞0.05).And the expressions of the Coriolis somatogyral illusions were multiform.Under three different speeds,the Coriolis somatogyral illusions showed no significant difference when the pilot's head pitched down (X2 ＝ 1.810,P＞0.05).The case of Coriolis somatogyral illusions was very rare when pilot's head pitched up and the result was not taken into account.③The scores of vestibular autonomic reaction were increased with the rotation speed increase,and showed significant difference (F＝ 15.058,P＜0.01).When the speed was 37 r/min,the score of vestibular autonomic reaction was significantly higher than the scores of 21 r/min and 30 r/min (P＜0.01 or P＜0.05),and there was no significant difference between the scores of 21 r/min and 30 r/min (P＞0.05).Conclusions When the speed of centrifuge was 30 r/m in,the induced rate of the vestibular illusions was the highest and the vestibular autonomic reaction was mild.For the 2 m arm centrifuge,the 30 r/min rotation was appropriate for pilots' vestibular illusion simulation training on the ground.

Objective To observe the effects and characteristics of vestibular illusions and vestibular autonomic reactions induced by short arm centrifuge exposure,and to search the appropriate rotation speed of short arm centrifuge for vestibular illusion simulation training on the ground.Methods Ninety healthy pilots were divided into 3 groups by the rotation speed of 21,30 and 37 r/min that generated by SAC-Ⅲ short arm centrifuge.By referencing the vestibular illusions simulation training on electric rotating chair,they were exposure to the simulation of counter-rotatory illusion and Coriolis illusion.Vestibular illusions and vestibular autonomic reactions were compared.Results ①When the speed was 21 r/min,the induced rates of the counter-rotatory illusion,Coriolis tumbling illusion (including head turn to right and to left) and Coriolis somatogyral illusion (including head pitched up and down) were lower than the induced rates under the speed of 30 r/min and 37 r/min (X2＝6.477 20.000,P＜0.01 or P＜0.05).And when the speed was 30 r/min and 37 r/min,the induced rates showed no significant difference (x2 ＝0.073-0.351,P＞0.05).②The expressions and characteristics of the centrifuge evoked counter-rotatory illusion were approximately the same under three different rotation speeds,while the illusion strength was enhanced with the speed increase.The expressions and characteristics of the Coriolis tumbling illusion induced by different speed showed no significant difference (X2 ＝0.090,0.056,P＞0.05).And the expressions of the Coriolis somatogyral illusions were multiform.Under three different speeds,the Coriolis somatogyral illusions showed no significant difference when the pilot's head pitched down (X2 ＝ 1.810,P＞0.05).The case of Coriolis somatogyral illusions was very rare when pilot's head pitched up and the result was not taken into account.③The scores of vestibular autonomic reaction were increased with the rotation speed increase,and showed significant difference (F＝ 15.058,P＜0.01).When the speed was 37 r/min,the score of vestibular autonomic reaction was significantly higher than the scores of 21 r/min and 30 r/min (P＜0.01 or P＜0.05),and there was no significant difference between the scores of 21 r/min and 30 r/min (P＞0.05).Conclusions When the speed of centrifuge was 30 r/m in,the induced rate of the vestibular illusions was the highest and the vestibular autonomic reaction was mild.For the 2 m arm centrifuge,the 30 r/min rotation was appropriate for pilots' vestibular illusion simulation training on the ground.

Objective To investigate the feasibility, rationality and efficacy of the autologous dermal-fat composite tissue used as filling materials in the repair of nasal dorsum collapse.Methods The dermal fat composite tissue block (7.0 cm× 1.0 cm × 1.0 cm) was removed from the buttocks or abdoman as filling materials. 13 cases of nasal dorsum and nasal-shaped misfits were treated by using an umbrella graft of the auricular cartilage plus dermal-fat composite tissue graft to reconstruct natual shape of nasal dorsum and tip. Results The nasal dorsum and tip were repaired in 13 patients with collapsed nasal dorsum. The dermal-fat composite tissue survived well, and the incisions were healed in stage Ⅰ and the incision trace was not obvious. After follow-up for one year, the shape of nose was much satisfactory. Conclusion It is a well-accepted and easy-going procedure to repair collapsed nasal dorsum with autologous dermal-fat or a combination of composite ear cartilage tissue graft, with satisfactory effect and no rejection reactions.

BACKGROUND: Left ventricular hypertrophy induced by primary hyper tension is a risk factor which has a dependent effect on various cardiovas cular complications. Reversal left ventricular hypertrophy has been a keyobject for treating hypertension currently. Plasma neuropeptide Y has en dothelium-derived contracting blood vessel, and has adjusting effect on va somotor function through endothelial cell to participate in onset and main tenance of hypertension. OBJECTIVE: To investigate effect of yixin jiangya capsule on left ven tricular mass index (LVMI) and content of neuropeptide Y of primary grade2 hypertensive patiepts with left ventricular hypertrophy of hyperactivity ofyang due to yin deficiency blood stasis. DESIGN: Case analysis on the basis of patients. SETTING: Department of Traditional Chinese Medicine, General Hospitalof Jinan Military Area Command of Chinese PLA; Department of InternalMedicine, Affiliated Hospital of Shandong University of Traditional Chi nese Medicine. PARTICIPANTS: Totally 93 primary grade 2 hypertensive patients withleft ventricular hypertrophy of hyperactivity of yang due to yin deficiency blood stasis were selected from General Hospital of Jinan Military AreaCommand of Chinese PLA and Affiliated Hospital of Shandong University of Traditional Chinese Medicine from March 2003 to August 2005. All cases were divided into two groups according to random digital table. There were 62 cases in observational group including 40 males and 22 females aged from 46 to 70 years with mean age of 58.94 years and coursed from 2 to 19 years with mean course of 8.93 years. There were 31 cases in control group including 19 males and 12 females aged from 44 to 69 years with mean age of 59.27 years and coursed from 2.5 to 18 years with mean course of 9.11 years. Another 30 people were regarded as healthy group.METHODS: Patients in both groups were treated with enalaprol orally with 10 mg each time of once a day. Patients in observational group were also treated with yixin jiangya capsule (component: shengrlihuang, shengshouwu, sangjisheng, chuanniuxi, gouteng, shijueming, xiakucao, tianma,mudanpi, chishaoyao, dilong, chuanshanjia, etc. Mixed according to ratio,extracted, concentrated, made of capsule, 0.5 g/pill, 4.65 g/raw drug, provided by Shandong Jinan Hongjitang Pharmacy Limited-liability Company,batch number:. 021214), 5 pills once for 3 times every day. Courses in both groups were 24 weeks respectively. LVMI and content of neuropeptide Y were measured with ultrasonic cardiograph and radio-immunity analysis method before and after treatment. Meanwhile, indexes mentioned above were also measured in healthy group so as to regard as the controls.MAIN OUTCOME MEASURFS: LVMI, content of neuropeptide Y,changes of blood pressure, adverse events and side effects.RESULTS: Totally 93 patients entered the final analysis. ① LVMI and content of neuropeptide Y were increased both observational group and control group before treatment [(147.2±16.9), (146.7±17.2), (101.8±.22.4) g/m2;(135.4±33.2), (133.8±31.1), (78.6±24.5) ng/L.; P ＜ 0.01]. ② LVMI and content of neuropeptide Y were decreased both observational group and control group after 24-week treatment, and those in observational group were superior to those in control group [(103.9±24.6), (122.6±19.9) g/m2;(82.9±25.2), (113.7±26.2) ng/L; P ＜ 0.05-0.01]. ③ LVMI and content of neuropeptide Y in observational group were not significantly different from those in healthy group increased both in observational group and control group after treatment (P.＞ 0.05), and those in control group were higher than those in healthy group (P ＜ 0.01). ④ Descent levels of systolic pressure and diastolic pressure were not significantly different between observational group and control group [(137.4±12.8), (134.2:t:11.9) mm Hg;(80.1±8.3), (81.7±7.4) mm Hg, P ＞ 0.05]. Blood routine and liver-kidney function were not changed obviously both groups before and after treatment, and side effect was not observed during the process.CONCLUSION: LVMI and content of neuropeptide Y of primary grade 2 hypertensive patients with left ventricular hypertrophy of hyperactivity of yang due to yin deficiency blood stasis are higher than those of healthy people. Yixin jiangya capsule can deteriorate left ventricular hypertrophy and decrease the content of neuropeptide Y on the basis of application of enalaprol.

OBJECTIVE:To prepare buspiron hydrochloride sustained-release tablets and to study its release characterization in vitro and the factors affecting drug release.METHODS:Buspiron hydrochloride sustained-release tablets were prepared with hydroxypropyl methylcellulose(HPMC)as hydrophilic gel-matrix material and ethylcellulose(EC)as retarder by wet granulation.The impacts of releasing transmitters,contents of HPMC and EC,and viscosity on the drug release in vitro of the tablets were studied.RESULTS:For the prepared sustained release tablets,the 24h drug release amount was over 90%,and the drug release curve conformed to Higuchi equation.The more contents of HPMC and EC and the higher viscosity of HPMC in the tablets,the slower drug release velocity was obtained;but the viscosity of EC and the releasing transmitters had no significant impacts on the drug release velocity.CONCLUSION:With HPMC and EC as matrix materials,the 24h continuous drug release is available for buspirone hydrochloride sustained-tablets.

Objective To optimize the preparation of nanoparticles encapsulating antisense oligodeoxynucleotides in a-butyleyanoacrylate carrier (ASODN in NP) and investigate their stability. Methods ASODN in NP were prepared by interfacial polymerization of butyleyanoacrylate (BCA). The formulation and technology of the prepared NP was optimized by using orthogonal design based on the single-factor experiment. The morphology of NP was examined by transmission electron microscope; The size and size distribution of NP were determined by Malvern laser granularity equipment;The encapsulation efficiency and drug loading were determined by HPLC; The ability of protecting oligodeoxynucleotides from serum was investigated on a 20% polyacrylamide-7 Murea sequencing gel (PAGE). Results The nanoparticles in the optimal conditions were of regular spherical surface and discrete. The average size was 97.1 nm,the average encapsulation efficiency and drug loading of ASODN in NP were 96.7% and 10.1% respectively; The oligonucleotides were more efficiently protected from degradation by nucleases than by oligonucleotides adsorbed into nanospheres.Conclusion ASODN in NP has good stability,encapsulation efficiency,drug loading and great potential for ASODN delivery.