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Chronic pulmonary aspergillosis (CPA) is a serious fungal infection, which complicates pulmonary tuberculosis, chronic obstructive pulmonary disease and sarcoidosis with high mortality. At present, the treatment of CPA include drug treatment and surgical treatment. The treatment plan should be determined by the type, clinical manifestations and surgical indications of the patients. Nevertheless, there is no standard plan, and more research is needed to improve it. Combined with the current literature reports, this article reviews the current and progress in the treatment of CPA.
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Objective To investigate the therapy effect of fermented cordyceps powder on diabetic cardiomyopathy, and the effect on expressions of NLRP3, Caspase-1 and interleukin (IL)-1βin myocardium of diabetic rats. Methods A total of 45 male SD rats were randomly divided into normal control group (group CON), diabetes group (group DM) and fermented cordyceps powder administration group (group CS, 1 g · kg-1 · d-1). Diabetes rat model was induced by tail vein injection with streptozotocin (45 mg/kg) in group DM and group CS. The rats in group CS were given fermented cordyceps powder solution by gavage at a single dose of 1 g·kg-1·d-1 for 18 weeks. Rats of group CON and group DM were given 0.9%NaCl in the same way. All rats were sacrificed after 18 weeks. The pathological changes in myocardium were observed by HE staining and electron microscope. The expression of NLRP3 in myocardium was detected by Western blotting. The expression levels of NLRP3, Caspase-1 and IL-1βin myocardium were detected by immunohistochemistry. Results (1) Myocardial necrosis and fibrosis and mitochondrial damages were observed under electron microscope in group DM. The above-mentioned pathological changes were improved in the group CS. (2) The result of Western blotting showed that the expression of NLRP3 in myocardium was significantly increased in group DM and group CS than that in group CON, and the expression of NLRP3 was significantly lower in group CS than that in group DM. (3) The result of immunohistochemistry showed that, compared with the group CON, the expressions of NLRP3, Caspase-1 and IL-1β in myocardium were significantly increased in group DM and group CS, and which were significantly lower in group CS than those in group DM. Conclusion Fermented cordyceps powder can improve diabetic cardiomyopathy through decreasing the expressions of NLRP3, Caspase-1 and IL-1βin myocardium.
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Objective To investigate the effect of Jinqi Jiangtang tablet on the activation of T helper type 17 (Th17) and the expressions of interleukin (IL)-17 and IL-23 in kidney of diabetic rats. Methods A total of 45 male SD rats were randomly divided into normal control group (NC, n=15) and experimental group (n=30). Diabetes was induced by tail vein injection with streptozotocin (STZ, 45 mg/kg). The well-established 28 diabetic model rats were then randomly divided into diabetes group (DM, n=14) and Jinqi Jiangtang tablet administration group (Jinqi, n=14). The rats in Jinqi group were given Jinqi Jiangtang tablet solution by gavage at a single dose of 2.1 g·kg-1·d-1 for 18 weeks, while NC group and DM group were given 0.9%NaCl in the same way. All rats were sacrificed after 18 weeks. The circulating Th17 frequencies were assessed using flow cytometry. Serum IL-17 and IL-23 levels were measured by enzyme-linked immunosorbent assay. The pathological changes in kidney were studied by electron microscope. The expressions of IL-17 and IL-23 in kidney were detected using immunohistochemistry. Results (1) Compared with the group NC, the circulating Th17 frequencies were significantly increased in group DM and group Jinqi. The circulating Th17 frequencies were significantly lower in group Jinqi than those in group DM. (2) Compared with the group NC, the serum IL-17 and IL-23 levels were significantly increased in group DM and group Jinqi. The serum IL-17 and IL-23 levels were significantly lower in group Jinqi than those in group DM. (3) In group DM, irregular thickening of glomerular basement membrane, fusion of epithelial cell foot processes and mesangial expansion were observed by electron microscope. The above-mentioned pathological changes were improved inthe group Jinqi. (4) Compared with the group NC, the expressions of IL-17 and IL-23 in the renal cortex were significantly increased in group DM and group Jinqi, and those were significantly lower in group Jinqi than those in group DM. Conclusion The activation of Th17 and the increased expressions of IL-17 and IL-23 in kidney play a potential role in diabetic nephropathy. Jinqi Jiangtang tablet can improve diabetic nephropathy through inhibiting the activating Th 17 and decreasing the expression of IL-17 and IL-23 in kidney.
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Objective To study the effect of potassium chloride (KCl) before CPR on successful resuscitation of rats with ventricular fibrillation (VF).Methods Sprague-Dawley (SD) rats with VF induced by alternating electricity current were randomly (ramdam runmber) divided into KCl group and normal saline (NS) group.Rats of two groups were prepared with 0.8 mL/kg of 2.5％ KCl in KCI group and equivalent volume of NS in NS group instead before CPR.The resuscitation was considered to be failure if ROSC was absent for 10 min.The comparisons of time required for ROSC,the average attempt of defibrillation,the average joule used for defibrillation,ROSC rate and 72 h survival rate were carried out between the two groups.Results The length of time required for ROSC in the KCl group (n =10) was shorter than that in NS group (n=10) [(283.89±152.44) svs.(404.38±164.27) s] (t=1.369,P =0.196).The average attempt of defibrillation in KCl group were fewer compared to the NS group [(1.50 ± 0.75) times vs.(2.66 ± 0.57) times,(t =2.701,P =0.022)],the average joule used for defibrillation in KCl group were less compared to NS group [(3.75 ± 2.86) J vs.(8.33 ± 2.88) J,(t =2.78,P =0.019)].The ROSC rate in the KCl group was higher than that in NS group (P =0.011).The 72 h survival rate in KCl group was higher than that in NS group (P =0.001).Conclusions Increasing plasma potassium level before CPR could increase the ROSC rate and survival rate in rats with VF.
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In the circumstance of that the medical system reform follows to the principle of combination of government leading and market mechanism and in view of medical ethics boundary and stratification, this paper pointed out that whether the discussion and introspection of society or the doctors,medical decision-making should focus on the relationship between medical behavior and the patients′health interests, which is ensured by reasona-ble system. Decided by the current situation of medical decision -making stratification, layered construction of medical ethics is beneficial to that the medical behaviors gradually regress to the ethical value, while establishment of diagnosis and treatment norms is the ethical choice of current medical decision-making.
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Objective To investigate whether increasing the concentration of serum potassium facilitates the cardioversion to sinus rhythm during cardiopulmonary resuscitation (CPR) in a rat ventricular fibrillation (VF) model. Methods Sprague-Dawley (SD) rats with sustained VF by electrical induction were randomized into two groups by random number table. Five minutes after onset of electrical induction, 2.5% potassium chloride solution at a dose of 0.8 mL/kg (KCl group, n = 9) or equivalent normal saline (NS group, n = 9) was given respectively via femoral vein followed by traditional CPR. The changes of electrocardiogram (ECG) and the effect of defibrillation were compared between the two groups. Results During the CPR, the number of animals with spontaneous cardioversion (2 vs. 1, P = 1.000) and successful defibrillation (7 vs. 3, P = 0.026) were both increasing in KCl group compare with those in the NS group, which required fewer defibrillation (1.60±0.79 vs. 2.70±0.58, P = 0.064), lower calculative defibrillation energy (J: 4.00±3.00 vs. 8.30±2.89, P = 0.068), more animals restore spontaneous circulation (ROSC, 9 vs. 4, P = 0.029) and shorter ROSC time (s: 265.10±134.58 vs. 421.30±162.06, P = 0.096). At the beginning of CPR, animals in two groups all presented the fine amplitude (amplitude < 0.5 mV). At CPR 3 minutes the KCl group presented significantly larger amplitude compared with NS group (mV: 0.92±0.16 vs. 0.67±0.23, P = 0.030); The amplitude decreased in the animals which did not attain cardioversion to sinus rhythm over time. The animal number of fine amplitude at CPR 7 minutes were 0 and 5, respectively, in the KCl group and the NS group. Conclusion Increasing serum potassium concentration facilitates the VF amplitude enlargement, promotes the spontaneous conversion, increases the successful rate of defibrillation and reduces the energy for defibrillation in a rat VF model.
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Critical Discourse Analysis ( CDA) attempts to uncover the inequality in social reality and the way language presents power and ideology through the analysis of language features. Systemic functional linguistics ( SFL) focuses on the dialectical relationship between language and society and has been considered an important approach and theoretical basis to CDA. Doctors in Chinese medical clinic follow the Four Diagnostic Methods, within which the inquiry diagnosis strongly shows the fact that doctor and patient clash over the ideology and strug-gle for the power via language. The study carries out CDA on doctor-patient discourse in Chinese medical clinic within the theoretical framework of SFL from four aspects including nominalization, classification, transitivity and mood, which verifies that the language is the product of asymmetric power between doctor and patient. It is hoped that the paper would provide insight into CDA on doctor-patient discourse and would be of theoretical meaning.
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Objective To observe the relationship between clinical medication and the prognosis in elderly community-acquired pneumonia (CAP).Methods A prospective randomized controlled single-blind study in Tianjin Hospital Internal Medicine.A total of 160 elderly patients with CAP were selected from January 2011 and January 2015.According to the computer,patients were randomly divided into treatment group and control group,80 cases in each group.Treatment group adopted routine treatment and moderate amount of glucocorticoids in combination with a low-dose of diuretic,and the control group only received routine treatment.In two groups of patients,we observed the initial treatment effect,change in pulse oxygen saturation,the rate of invasive test,the incidence of adverse reactions,mortality rate,total hospital stay,etc.Results Compared with control group,the initial treatment was better,the improvement rate in SPO2 was increased,and the rate of invasive test was decreased in treatment group 72 hours after treatment (x2 =6.234,3.906 and 7.059,respectively,P=0.013,0.048 and 0.008).After the overall prognosis and outcome analysis,compared with control group,the percentage of patients transferred to the intensive care unit,the mortality rate was decreased (x2=4.783 and 4.737,P=0.029 and 0.030),hospitalization cost was declined,and the total hospital stay was shorted (x2 =-72.087 and-5.127,both P＜0.0001).There was no statistically significant difference in the incidence of adverse reactions such as electrolyte disorder and mental disorder(both P＞0.05).Conclusions Corticosteroids in combination with a low-dose of diuretic for the auxiliary treatment of elderly CAP can reduce the mortality rate,decrease the rate of invasive test,and shorten the duration of hospitalization,with no obvious increase of adverse events,and it help to improve the prognosis of CAP patients.
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This paper focused on the role conflicts owing to the multiple identity of roles and professional limi -tations in the dispute processing personnel , analyzed the probability in the medical processes and results , appeal of the patients and pattern of medical dispute processing , and made the conclusion that the medical dispute processing personnel is volunteers promoting social harmony and a practitioner of new medical model from the social perspec -tive and should carry forward the dedication , fraternity, mutual assistance and progressive spirit , the concept of the biological -psychology -social medical model to analyze the loss of patients in dispute and appeal , truly safe-guard the health rights and interests of patients , and give some advices to perfect the role ethics dispute processing .