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Objective To study the success rate of ventilator weaning in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients influenced by bobbed endotracheal intubation. Methods One hundred and sixteen AECOPD patients who were given invasive mechanical ventilation and reached the standards of off-ventilator were divided into control group (general endotracheal intubation group) and experiment group bobbed (tracheal intubation) by random digits table method with 58 cases each. The respiratory rate (RR), heart rate (HR), rapid and shallow breathing index (RSBI), oxygenation index (OI), pulse blood oxygen saturation (SpO2), tidal volume and success rate of ventilator weaning were compared. Both groups were implemented of extubation if they reached the standards of the extubation time by observing their ability in spontaneous breathing test (SBT). Results The RR, HR and RSBI before extubation in experiment group were significantly lower than those in control group:(19.7 ± 2.3) times/min vs. (23.5 ± 2.3) times/min, (91.2 ± 6.3) times/min vs. (93.4 ± 8.1) times/min and 80.2 ± 6.7 vs. 90.5 ± 9.6, P<0.05, and the OI, SpO2, tidal volume and success rate of ventilator weaning were significantly higher than those in control group: (269 ± 9) mmHg (1 mmHg = 0.133 kPa) vs. (245 ± 16) mmHg, 0.929 ± 0.014 vs. 0.870 ± 0.037, (6.1 ± 1.2) ml/kg vs. (5.1 ± 0.8) ml/kg and 91.38%(53/58) vs. 77.59%(45/58), P<0.05. Conclusions The bobbed endotracheal intubations can improve the success rate of ventilator weaning in patients with AECOPD.
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Objective To observe the clinical efficacy of diltiazem in patients with coronary disease following percutaneous coronary intervention(PCI).Methods From Jan 2014 to Jan 2016,116 cases of coronary disease were selected as the research subjects,they were randomly divided into the observation group(62cases)and the control group(54 cases).The control group was given conventional therapy,while the observation group was given diltiazem therapy on the basis of control group.The levels of BP,HR,NT -proBNP,CRP and angina frequency in the two groups were compared before and 24h,48h after PCI.The incidence of major adverse cardiovascular events(MACEs) was assessed at the sixth month after PCI.Results After surgery,the CRP levels of the observation group and control group were (40.1 ±7.4)mg/L and (41.7 ±8.8)mg/L,the NT -proBNP levels of the two groups were (501.8 ± 56.5)ng/L and (445.7 ±50.6)ng/L,which were significantly higher than preoperation(t =5.684,P <0.05).The blood pressure,heart rate,CRP,NT -proBNP of the observation group since 24 hours after PCI were (73.1 ± 6.2)mmHg,(121.7 ±15.8)mmHg,(68.1 ±7.9)times/min,(24.8 ±3.7)mg/L,(201.7 ±20.6)ng/L,which were significantly lower than those of control group [(85.6 ±9.3 )mmHg,(134.3 ±17.4)mmHg,(77.5 ± 9.2)times/min,(36.5 ±7.9)mg/L,(481.5 ±48.2)ng/L].The effect was kept over 48 hours(F =7.281,8.097, 6.945,7.682,6.517,all P <0.05).Angina pectoris after treatment in the observation group and control group were (1.5 ±0.9)times/month,(2.9 ±0.7)times/month,which were significantly lower than before treatment(t =7.584,P <0.05).The incidence rate of total MACE in the observation group was 4.84%,which was significantly lower than that in the control group(χ2 =6.942,P <0.05).Conclusion Diltiazem after PCI can decrease the adverse reaction, and help to improve the prognosis of patients.
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Objective To investigate the clinical value of serum pepsinogen(PG)Ⅰ,Ⅱ and gastrin-17(G-17)levels in early di-agnosis for atrophic gastritis and gastric cancer.Methods The study was performed on a case-control trial,and 430 subjects were recruited.Each of them underwent endoscopy biopsies before serum tests were performed.These patients were further divided into three groups based on endoscopic and histological findings:160 non-atrophic gastritis group,118 atrophic gastri-tis group and 152 gastric cancer group.Serum samples of PGⅠ,PGⅡ and G-17 were analyzed by enzyme-linked immunosor-bent assay(ELSIA),and calculated the values of PGⅠ/PGⅡratio.Results Compared with the non-atrophic gastritis group, serum PGⅠ and G-1 7 values in atrophic gastritis and serum PGⅠ,PGⅡ,PGⅠ/PGⅡratio and G-1 7 values in gastric cancer group decreased significantly (P<0.05);compared with the atrophic gastritis group,serum PGⅠ and G-17 values in gastric cancer group decreased significantly (P<0.05).By using receiver operating characteristic curves (ROC),the cut-off points of PGⅠ84.706μg/L,PGⅡ 10.873μg/L,PGⅠ/PGⅡ ratio 11.008 and G-178.265 pg/L in atrophic gastritis group,PGⅠ65.145μg/L,PGⅡ 10.089μg/L,PGⅠ/PGⅡ ratio 6.375 and G-17 4.971 pg/L in gastric cancer group.Conclusion Low serum PGⅠ,PGⅡ,PGⅠ/PGⅡ ratio and G-1 7 values are biomarkers of atrophic gastritis and gastric cancer and valuable for the early diagnosis of gastric cancer.
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OBJECTIVE To discuss the present situation of the medical ethics education and the significance to carry out in the nosocomial infection management. METHODS The method was retrieved the nosocomial infection management and the medical ethics education related monographs and publications in recent years,and to analyze and comment the environmental condition and necessity of the development of the medicine ethics education study. RESULTS Finally some hospitals developed the nosocomial infection medical ethics to educate,and carried on the preliminary ponderation over the nosocomial infection and the medicine ethics,but the infection management medical ethics standard was still at the vacuum stage,current the environment was in favor of the medical ethics education. CONCLUSIONS Through the development of the series medicine ethical education and the introduction of medical ethics appraisal and ethics analysis,from the macroscopic height and philosophy influence the medical personnel,promote the nosocomial infection management achievements,and guarantee to realize the infection foundation work. As the carrier of the achievement impelling the hospital culture,it has poured the soul into the nosocomial infection supervisory work.
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<p><b>OBJECTIVE</b>To assess the atherogenicity of lipoprotein(a), the effect of the heterogeneity of lysine binding of apolipoprotein(a) [apo(a)], a plasminogen-like glycoprotein component on the proliferation of human arterial smooth muscle cells (SMCs).</p><p><b>METHODS</b>Both wild type (wt) Trp72 and mutant (mut) Trp72-->Arg forms of apo(a) kringle IV-10 were expressed by employing a GST-gene fusion system into E. coli. The proliferation of SMCs was determined by flow cytometry and MTT colorimetry. Enzyme-linked immunosorbent assay (ELISA) assay was used to detect the active form of transforming growth factor beta(1) (TGF-beta(1)).</p><p><b>RESULTS</b>Apo(a) wt-kringle IV-10 that has lysine binding properties possessed a growth-stimulating activity to SMCs on a dose-dependence manner by stimulating cells in the G(1)/G(0) phase of cell cycle to S and G(2)/M phase, and reduced significantly the amounts of endogenous active TGF-beta(1) in culture when compared with the control medium and the GST group (2.4 +/- 0.5 vs 8.6 +/- 1.6 and 9.1 +/- 1.7 ng/ml, P < 0.01). The growth-stimulating effect of apo(a) mut-kringle IV-10 deficient in lysine binding was negligible.</p><p><b>CONCLUSIONS</b>Apo(a) induces SMCs growth by inhibiting the activation of latent TGF-beta(1), an activity that may involve the ability of apo(a) kringle IV-10 to bind lysine. The mitogenic effect of apo(a) wt-kringle IV-10 on SMCs might play an active role in the atherogenic function of lipoprotein(a).</p>
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Humans , Apolipoproteins , Genetics , Metabolism , Apoprotein(a) , Cell Division , Physiology , In Vitro Techniques , Kringles , Genetics , Lipoprotein(a) , Genetics , Metabolism , Muscle, Smooth, Vascular , Cell Biology , Transforming Growth Factor beta , MetabolismABSTRACT
OBJECTIVE: To investigate the effects of episodic hypoxia(EHYP) on liver CYP3A2 and CYP2E1. METHODS: Healthy masculinity rats were divided randomly into five groups: control group, 3 -day EHYP group, 7 -day EHYP group, 14 -day EHYP group, and 28 -day EHYP group. 24 h after the management of EHYP, the rats were anesthetized by intraperitoneal injection, and the eyeball blood 2ml was drawn to prepare serum. The activities of ALT and AST in the serum were determined by enzymatic methods. The activities of liver microsomal erythromycin demethylase(ERD) and aniline hydroxylase(ANH) were detected by spectrophotography. The levels of mRNA expression of CYP3A2,CYP2E1 were assayed with RT-PCR. RESULTS: The serum activities of ALT,AST showed no remarkable change. However, after 7 days of hypoxia, ERD and ANH activities were remarkably elevated, and at 28 days induction rates reached up to155.5% and 42.2%, respectively. Meanwhile, the levels of mRNA expression of CYP3A2,CYP2E1 also increased by 220.5% and 102.8%, respectively. CONCLUSION: Chronic EHYP can remarkably increase the activities of ERD and ANH, whose mechanism is probably related to up-regulating of CYP3A2 and CYP2E1 expression at the transcriptive level.
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AIM: To observe whether arachidonic acid (AA) could induce apoptosis in mouse fibroblast cell line L929 and the potential mechanism involved. METHODS: The viability and damaged degree of L929 was monitored by MTT and the release of lactate dehydrogenase (LDH). Lipid peroxidation in L929 was measured as malondialdehyde (MDA) content by colorimetric assay. Hoechst 33258 staining was used to observe AA-induced morphological changes. Agarose gel electrophoresis was used to detect DNA fragmentation. RESULTS: Treatment of L929 cell with AA for 24 h, in the range of 40-160 ?mol/L, caused a great decrease in cell survival and increased MDA contents and the release of LDH simultaneously( P
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AIM: To explore the effects of homocysteine on the apoptosis in PC12 cells and the relationship between the apoptosis and the expression of the bcl-2 as well as bax gene. METHODS: Cell viability was determined by MTT assay. Cell apoptosis was assessed by phase-contrast microscope, fluorescence microscopy and flow cytometry (FCM). The expression of bcl-2 and bax mRNA was measured by semiquantitative reverse transcription polymerse chain reaction (RT-PCR). RESULTS: Treatment of PC12 cells with Hcy plus 10 ?mol/L copper for 12 h, in the range of 0.125, 0.25, 0.5, 1.0 mmol/L, caused a great decrease in cell viability: 81%, 79%, 69%, 57%, and induced typical morphological changes of apoptosis in a dose-dependent manner. The apoptosis ratios were respectively 8.00%, 10.37%, 17.26% and 20.19%, respectively. The expression of bcl-2 was significantly decreased (from 0.517 to 0.198) whereas bax was significantly increased (from 0.302 to 0.619). CONCLUSION: Homocysteine plus copper may induce apoptosis in PC12 cells through the down-regulation of bcl-2 and the up-regulation of bax gene expression.