Objective To observe the level of cellular immune function in the patients with stable chronic obstructive pulmonary disease(COPD),and also to investigate the effects of hyperbaric oxygen (HBO) on the cellular immune function in the patients with stable COPD.Methods One hundred and sixty-seven cases of stable COPD were divided into 2 groups,the drug inhalation group (n =81),which inhaled tiotropium bromide and the HBO group (n =86),which received HBO therapy in addition to drug inhalation.Another 33 normal health subjects were recruited as the normal control group.Immune function indexes of the 3 groups were detected and analyzed before and after therapy.Results The IL-2R level and lymphatic metastasis rate of the HBO group and the drug inhalation group were respectively [(218.95 ± 106.60) μg/ml,(235.60 ± 67.85)μg/ml] and [(42.15 ± 5.75)％,(42.52 ± 5.75)％],CD3 and CD4 levels were respectively [(47.05±7.76)％,(47.20 ±7.63)％] and [(36.20 ±6.05)％,(34.67 ±4.51)％].Statistical significance could be found when they were compared with those of the normal control group [(389.13 ± 191.42)μg/ml,(77.60±5.29)％,(65.70±6.30)％,(44.50±4.70)％](P＜0.01).For the HBO group,significant improvement could be seen in cellular immune indexes,pulmonary ventilation function and hypoxemia after therapy,and there was statistical significance when compared with those data before therapy (P ＜ 0.05).There was also significant improvement in cellular immune indexes for the patients of the HBO group,as compared with those of the drug therapy group,and statistical significance could be noted when comparisons were made between the 2 groups (P ＜ 0.01).Conclusions The cellular immune levels of the patients with stable COPD were decreased to various degrees.HBO therapy could significantly improvethecellular immune function of the patients with stable COPD,rectify hypoxia and carbon dioxide retention and improve pulmonary function.

Objective To observe the level of cellular immune function in the patients with stable chronic obstructive pulmonary disease(COPD),and also to investigate the effects of hyperbaric oxygen (HBO) on the cellular immune function in the patients with stable COPD.Methods One hundred and sixty-seven cases of stable COPD were divided into 2 groups,the drug inhalation group (n =81),which inhaled tiotropium bromide and the HBO group (n =86),which received HBO therapy in addition to drug inhalation.Another 33 normal health subjects were recruited as the normal control group.Immune function indexes of the 3 groups were detected and analyzed before and after therapy.Results The IL-2R level and lymphatic metastasis rate of the HBO group and the drug inhalation group were respectively [(218.95 ± 106.60) μg/ml,(235.60 ± 67.85)μg/ml] and [(42.15 ± 5.75)％,(42.52 ± 5.75)％],CD3 and CD4 levels were respectively [(47.05±7.76)％,(47.20 ±7.63)％] and [(36.20 ±6.05)％,(34.67 ±4.51)％].Statistical significance could be found when they were compared with those of the normal control group [(389.13 ± 191.42)μg/ml,(77.60±5.29)％,(65.70±6.30)％,(44.50±4.70)％](P＜0.01).For the HBO group,significant improvement could be seen in cellular immune indexes,pulmonary ventilation function and hypoxemia after therapy,and there was statistical significance when compared with those data before therapy (P ＜ 0.05).There was also significant improvement in cellular immune indexes for the patients of the HBO group,as compared with those of the drug therapy group,and statistical significance could be noted when comparisons were made between the 2 groups (P ＜ 0.01).Conclusions The cellular immune levels of the patients with stable COPD were decreased to various degrees.HBO therapy could significantly improvethecellular immune function of the patients with stable COPD,rectify hypoxia and carbon dioxide retention and improve pulmonary function.

The epileptic eye and head movements during epileptic seizures may be much more complicated thanpeople originally understood, which can be ipsilateral or contralateral to the electroencephalographyfocus. Here, we describe a male patient with drug resistant focal seizures associated with a directionalseparation between head and eye movement before evolving into generalized tonic-clonic seizure.His contralateral head leading turning showed forced, sustained, and unnatural features companiedby ipsilateral eye staring. Stereoeletroencephalography monitoring was performed, and 4 habitualseizures were recorded over 5 days. Three seizures showed left head leading turning and generalizedtonic-clonic seizure, and only one showed dizziness and ringing in the ears. All the seizures showedthat the ictal onset contacts were located in the posterior inferior temporal sulcus which borders onthe anterolateral part of medial superior temporal area. The patient underwent a resection includingtemporooccipital region, and the histopathology showed focal cortical dysplasia type Ic. He has beenseizure free for two years after operation. The scores of the intelligence and memory quotient improvedhalf year after operation.

Aim To explore the inhibition of Sinica Maxim′s extract( CSME) on resistant infections of burn wounds,such as the methicillin-resistant staphylococcus aureus ( MRSA ) , resistant pseudomonas aeruginosa (RPA) and resistant escherichia coli(RECO). Meth-ods The resistant strains were cultured by MH agar plates. After resistance genes of quality control strains were extracted and appraised, such as mecA, mexB, merA, qacE△1-sull, tnpU/A and mexB, etc, and then,some projects of CSME were detected,such as the antibacterial spectrum, the minimum inhibitory con-centration(MIC), different concentrations of sensitive rate and inhibition curves, etc. Finally, these results were compared with the inhibitory effects of some anti-biotics to determine the sensitivity rates of CSME. Re-sults The MIC of CSME was 62. 5 ,125 ,250 g · L-1 respectively on the MESA, RPA and RECO. The inhi-bition rates of CSME appeared concentration-dependent on these three kinds of resistant bacteria,and the inhi-bition rates of the multi-concentration CSME on RECO were significantly lower than on MRSA and RPA ( P<0. 05). While in MIC,the resistance rates of MRSA on carbenicillin, cefazolin, erythromycin were significant-ly higher than those of CSME(P<0. 05); The inhibi-tion zones of CSME were significantly smaller than those of ceftriaxone, cefepime, imipenem, but greater than those of other antibiotics( P<0. 05 ); The inhibi-tion zones of CSME on RPA were significantly smaller than those of carbenicillin, and greater than those of other antibiotics ( P <0. 05 ) . The inhibition zones of CSME on RECO were significantly smaller than those of ceftriaxone,cefepime,imipenem,ciprofloxacin,nitro-furazone,and greater than those of other antibiotics ( P<0. 05 ) . Conclusions CSME has a significant inhi-bition on burn wound infection with these three kinds of resistant bacteria,such as MRSA,RPA and RECO. It is prompted that CSME could become one of the effective drugs to control burn wound infections with multi-re-sistant strains.

OBJECTIVE:To provide reference for the identification,processing,processing technology and research for ther-mal decomposition products. METHODS:Thermogravimetry- derivative thermogravimetry (TG-DTG) and differential thermal-de-rivative differential thermal (DTA-DDTA) analysis were conducted to scan thermal spectrum of tripterygium from 3 places and T. hypoglaucum,T. regelii,common counterfeits Actinidia arguta and Vitis quinquangularis,determine 7 medicinal materials,its dregs and extractum,and analyze differential spectrum of T. wilfordii and dregs. RESULTS:The TG-DTG and DTA-DDTA thermal spectrum were not only basically similar to each other but also to their dregs. There was a singlet main characteristics peak at about (299±3)℃ only in the DTG curves of extracts of tripterygium from 3 places and T. hypoglaucum extractum with similar intensity, while T. regelii,counterfeits A. arguta and V. quinquangularis showed multiple peaks,and (299 ± 3)℃ was not the main peak. CONCLUSIONS:The thermal spectrum can not distinguish tripterygium and its counterfeits;extractum DTG curves can do it;suit-able processing temperature of tripterygium was 200-380℃. The study can provide reference for the identification,processing,pro-cessing technology and research for thermal decomposition products.

Objective: To explore the risk factors for Type 1 cardio-renal syndrome (CRS1) atfer ST-segment elevation myocardial infarction (STEMI). Methods: A total of 378 patients with STEMI were divided into two groups: a CRS1 group (n=98) and a non-CRS1 group (n=280). Clinical characteristics in the 2 groups were compared, and independent risk factors for CRS1 after STEMI were analyzed, and the effect of emergency Results: In the 378 STEMI patients, CRS1 was found in 98 patients (25.9%). Between the 2 groups, there was significant difference in 12 parameters, including age, history of diabetes, admission mean arterial pressure, admission systolic blood pressure, admission heart rate, Killip classification, left ventricular ejection fraction, baseline serum creatinine, baseline evaluated glomerular ifltration rate (eGFR), emergency PCI, β-blockers and angiotensin converting enzyme inhibitor/angiotensin, receptor antagonist (ACEI/ARB) application (allP<0.05). Multivariate logistic regression showed that age, history of diabetes, admission systolic blood pressure, Killip classification, reduced left ventricular ejection fraction, reduced eGFR, emergency PCI non-undergo and ACEI/ARB non-use were independent risk factors for CRS1 atfer STEMI. In the 256 patients undergoing emergency PCI, 50 patients (19.5%) had CRS1. hTe door-ball time and the amount of contrast agent in the CRS1 group were signiifcantly higher than those in the non- CRS1 group (bothP<0.05), but there was no signiifcant difference in the blood lfow in the “culprit vessel”atfer the PCI (P>0.05). Conclusion: CRS1 is a common complication of STEMI, which is associated with many factors. Immediate revascularization can reduce the incidence of CRS1 in patients with ST-segment elevation myocardial infarction.

Objective To predict the risk of 28-day mortality in septic patients in intensive care unit (ICU) with the combination of Weighted index of comorbidities (WIC) and sepsis-related organ failure assessment (SOFA) score.Methods The clinical data of adult severe sepsis/septic shock patients in Department of Emergency Medicine of Changzheng Hospital and Department of Critical Care Medicine of Jinan Military General Hospital from October 2011 to February 2013 were analyzed retrospectively.The etiological factor,past history,having severe sepsis or not were recorded.Age score,WIC score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and SOFA score were calculated at or 24 hours after admission.The logistic regression was used and the receiver operating characteristic curve (ROC curve) was drawn to calculate the patients' outcome.Results In 310 enrolled patients,223 (71.9％) patients survived and 87 (28.1％) died.Univariate analysis showed that the P values of the age score,WIC score,APACHE Ⅱ score and SOFA score,chronic cardiac insufficiency,type 2 diabetes,cerebrovascular disease,tumor,multiple injury,pulmonary infection and having severe sepsis or not were all less than 0.2.The above 11 variables were put into the multivariate logistic regression equation 1,of which predicted probability was reserved.It revealed that 5 variables were independently associated with 28-day prognosis,of which influence power in descending order were SOFA score [odds ratio (OR) =1.308,95％ confidence interval (95％ CI):1.158-1.478,P=0.000],having severe sepsis or not (OR =0.206,95％ CI:0.100-0.424,P=0.000),APACHE Ⅱ score (OR =1.090,95％CI:1.021-1.164,P=0.010),WICscore (OR=1.441,95％CI:1.067-1.947,P=0.017),agescore (OR=1.228,95％CI:1.027-1.468,P=0).024),the Walswere 18.554,18.369,6.725,5.662,5.067,respectively.The 3 variables,age score,WIC score and SOFA score,were brought into the multivariate logistic regression equation 2,of which predicted probability was reserved too.It revealed that age score (OR=1.330,95％CI:1.145-1.546,P=0.000),WIC score (OR =1.496,95％ CI:1.145-1.546,P=0.000) and SOFA score (OR =1.429,95％ CI:1.303-1.567,P=0.000),were independently associated with the septic patients' 28-day prognosis.There was no significant difference in the area under receiver operating characteristic curve (AUC) between the SOFA score and APACHE Ⅱ score (0.784 vs.0.780,Z=0.014,P=0.989).However,compared with APACHE Ⅱ score,the AUC of equation 1 (0.888) and 2 (0.851) were much more (Z=4.333,P=0.000; Z=2.669,P=0.008).Conclusion The sensitivity of 28-day prognosis by WIC score was improved greatly with the combination of SOFA score and age score.

Objective To estimate the predictive value of neutrophil gelatinase-associated lipocalin in urine (uNGAL) for detection of acute kidney injury (AKI) in the intensive care unit (ICU) critically ill patients.Methods A total of 110 patients from the ICU of three general hospitals were enrolled in the study.The patients were adults more than 18 years of age.After admitted to ICU,the patients were continuously observed for 72 hours.According to the RIFLE criteria for diagnosis of AKI,the patients were classified as AKI group (33 cases) or non-AKI (77 cases).According to the sepsis diagnostic criteria,the patients were classified as sepsis (79 cases) or non-sepsis (31 cases).Exclusion criteria of patients were chronic renal insufficiency,malignant tumor,death after admitted to ICU 24 hours.Serum creatinine and uNGAL of the patients were analyzed daily.The difference of uNGAL between sepsis and non-sepsis patients,AKI and non-AKI patients,sepsis non-AKI and sepsis AKI patients was compared.Moreover,the difference of serum creatinine and uNGAL between AKI and non-AKI patients into ICU 24 h was compared,and the sensitivity and specificity of uNGAL and serum creatinine for diagnosis of AKI in the ICU patients were evaluated using ROC curve.Results The uNGAL levels were all significantly different between sepsis and non-septis patients,AKI and non-AKI patients,sepsis concomitant AKI and sepsis without AKI patients.The uNGAL levels were significantly different between AKI and non-AKI patients in ICU for the first 24 h,while the difference of serum creatinine were not significant.The area under receiver operating characteristic (ROC) curve of uNGAL and serum creatinine of patients in ICU for the first 24 h were 0.828 (95％ CI:O.742-0.914) and 0.583 (95％ CI:0.471-0.695),respectively.The cutoff value of uNGAL was 170 ng/ml,and the sensitivity and specificity were 0.778 and 0.784,respectively.The sensitivity was superior to serum creatinine.Conclusions uNGAL was superior to serum creatinine in the diagnosis of AKI,and could be used as a marker of the early diagnosis of AKI.

Objective: To explore the cognitive level and the mental status of the patients suffering from perimenopausal syndrome in Shanghai, and to identify the traditional Chinese medicine syndrome distribution feature of perimenopausal syndrome. Methods: The cognitive level of the perimenopausal women was evaluated by using general living problem questionnaire. The mental status of the perimenopausal women was evaluated by using self-rating depressive scale. The traditional Chinese medicine syndrome distribution feature of perimenopausal syndrome was identified by using traditional Chinese medical symptoms questionnaire. Results: A total of 634 perimenopausal women finished the investigation. There were 74.76% (474/634) patients who knew little about the perimenopausal syndrome; 77.29% (490/634) patients had a depressive tendency; 8.36% (53/634) patients had depressive disorder. There were 72.40% (459/634) patients who had the symptoms such as susceptibility to anger and restlessness, restless sleep at night, thirst with dry throat and bitter taste, and all these symptoms could be classified into hyperactivity of heart and liver fire syndrome. Conclusion: Patients suffering from perimenopausal syndrome know little about this disease and mostly have depressive tendency, and the major traditional Chinese medicine syndrome pattern is hyperactivity of heart and liver fire based on the chief clinical manifestations of the patients.

OBJECTIVE: To determine the effect of Tongxinluo on the endothelial function and hypersensitive C-reactive protein (hs-CRP) in acute coronary syndrome patients undergoing percutaneous coronary intervention(PCI). METHODS: Thirty-three patients with unstable angina pectoris and 6 patients with acute myocardial infarction who underwent PCI for stenotic lesions of the coronary artery were enrolled. The patients were randomly assigned to a conventional group (n = 19) which took routine treatment or a tongxinluo group (n = 20) which took Tongxinluo(4 capsules once, 3 times per day) at the base of routine treatment after PCI. Nitric oxide synthase (NOS), nitric oxide (NO), endothelium-dependent vasodilation which was evaluated in the brachial artery flow mediated diameter(FMD) and hs-CRP were measured before the PCI and 24 hours and 3 months after the PCI. The correlation between NO and hs-CRP was analyzed. RESULTS: NOS, NO, and FMD in the 2 groups 24 hours after the PCI were significantly lower than those before the PCI(P < 0.05), but hs- CRP obviously increased (P < 0.05). NOS, NO, and FMD 3 months after the PCI in the 2 groups were significantly higher than those before the PCI (P < 0.05 or P < 0.01), but hs-CRP obviously decreased (P < 0.01).All indexes mentioned above in the Tongxinluo group showed greater changes than those of the conventional group(P < 0.05). NO was negatively correlated with hs-CRP (r = -0.3219, P<0.01). CONCLUSION Tongxinluo capsules have obvious beneficial effect on endothelial function and anti-inflammation in acute coronary syndrome patients undergoing PCI, by directly acting on the endothelium and indirectly inhibiting inflammation.
Acute Coronary Syndrome ; blood ; physiopathology ; therapy ; Aged ; Angioplasty, Balloon, Coronary ; methods ; C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy