Correlation between dead space fraction and pulmonary ultrasound score in patients with acute respiratory distress syndrome and its prognostic value / 中华危重病急救医学

Objective:To investigate the correlation between dead space fraction and lung ultrasound score (LUS) and their prognostic value in patients with acute respiratory distress syndrome (ARDS).Methods:The data of 98 patients with ARDS treated in the intensive care unit (ICU) of the First Affiliated Hospital of Jinzhou Medical University from January to December 2020 were collected and analyzed. The gender, age, acute physiology and chronic health evaluationⅡ(APACHEⅡ), oxygenation index, dead space fraction and LUS score immediately and 24, 48, 72 and 96 hours after ICU admission and 28-day outcomes of all patients were collected. Pearson correlation was used to analyze the correlation between dead space fraction and LUS score. Binary Logistic regression was performed to analyze whether the dead space fraction and LUS score could be the risk factors of the prognosis in patients with ARDS. Receiver operator characteristic curve (ROC) was used to analyze the predictive effect of dead space fraction and LUS score on 28-day mortality in patients with ARDS.Results:A total of 98 patients with ARDS were included, of which 76 cases survived and 22 cases died within 28 days. With the prolongation of ICU stay, the dead space fraction and LUS score in the survival group increased first and then decreased. The dead space fraction and LUS score in the death group continued to increase to 96 hours, and were significantly higher than those in the survival group (dead space fraction: 0.569±0.019 vs. 0.491±0.021, LUS score: 20.09±2.39 vs. 15.13±1.91, both P < 0.05). There was a positive correlation between the dead space fraction and LUS score at 48, 72 and 96 hours in ICU ( r values were 0.200, 0.471 and 0.677, all P < 0.05). Binary Logistic regression analysis showed that dead space fraction and LUS score were independent risk factors affecting the prognosis of patients with ARDS [dead space fraction: odds ratio ( OR) was 69.064, 95% confidence interval (95% CI) was 22.680-123.499, P = 0.008; LUS score: OR was 4.790, 95% CI was 1.609-14.261, P = 0.005]. The results of ROC curve analysis showed that the dead space fraction at 48, 72 and 96 hours after ICU admission could be used to predict the 28-day mortality of patients with ARDS, the sensitivity was 59.1%, 90.9% and 95.5%, and the specificity was 89.5%, 80.3% and 98.7%. The area under the curve (AUC) of dead space fraction predicting 28-day mortality was 0.802, 0.952 and 0.998, all P < 0.01. The LUS score of 72 hours and 96 hours in ICU could be used to predict the 28-day mortality of patients with ARDS, the sensitivity was 77.3%, 77.3% and 100.0%, and the specificity was 68.4%, 88.2% and 80.3%, respectively. The AUC of the LUS score to predict the 28-day mortality of patients were 0.935 and 0.959, both P < 0.01. Conclusion:There was significant correlation between dead space fraction and LUS score, both of which were risk factors of 28-day mortality and be used to evaluate the 28-day prognosis of patients with ARDS.

Clinical Study of Chaihu Shugansan Combined with Abdominal Acupuncture on Depression Caused by Chronic Pain / 中国实验方剂学杂志

Objective:To investigate the clinical effect of Chaihu Shugansan combined with abdominal acupuncture on depression caused by chronic pain，and to explore its mechanism. Method:A total of 97 patients with depression caused by chronic pain were randomly divided into control group （49 cases） and observation group （48 cases）. Patients in both groups received routine western medicine treatment，including necessary psychological intervention and taking paroxetine. Control groupobservation groupcontrol group Patients in control group were treated with Xiaoyaowan，and patients in observation group were treated with Chaihu Shugansan combined with abdominal acupuncture. Both groups were treated for 6 weeks. The levels of serum neurotransmitters，cytokines and Hamilton depression rating scale（HAMD） before and after treatment were compared between two groups<bold>.</bold> Result:There was no significant difference in HAMD scores of the two groups before treatment and the HAMD scores of two groups after treatment were significantly lower than those before treatment （<italic>P</italic><0.05），and the HAMD scores in observation group were significantly lower than those in the control group （<italic>P</italic><0.05）. There was no significant difference in the levels of serum 5-hydroxytryptamine （5-HT），norepinephrine （NE），and brain-derived neurotrophic factor （BDNF） between two groups before treatment. After treatment，the levels of serum 5-HT，NE，and BDNF in two groups were significantly higher than those before treatment （<italic>P</italic><0.05），and the levels in observation group were significantly higher than those in control group （<italic>P</italic><0.05）. There was no significant difference in the levels of serum interleukin-6 （IL-6），interleukin-1<italic>β</italic> （IL-1<italic>β</italic>） and tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） before treatment. After treatment，the levels of serum IL-6，IL-1<italic>β</italic> and TNF-<italic>α</italic> were significantly lower than those before treatment （<italic>P</italic><0.05），and the levels in observation group were significantly lower than those in control group （<italic>P</italic><0.05）. Conclusion:On the basis of psychological intervention and paroxetine administration，the combination of Chaihu Shugansan and abdominal acupuncture exerts their respective advantages. It treats both symptoms and root causes of depression，relieves the degree of depression，reduces the classification of depression，and regulates the levels of neurotransmitter and cellular inflammatory factors，and inhibits inflammatory response. The clinical effect is significant.

Effect of hyperoxic exposure on the expression of heme oxygenase-1 and glutamate-L-cysteine ligase catalytic subunit in lung tissue of preterm rats / 中国当代儿科杂志

OBJECTIVE@#To study the effect of hyperoxic exposure on the dynamic expression of heme oxygenase-1 (HO-1) and glutamate-L-cysteine ligase catalytic subunit (GCLC) in the lung tissue of preterm neonatal rats.@*METHODS@#Cesarean section was performed for rats on day 21 of gestation to obtain 80 preterm rats, which were randomly divided into air group and hyperoxia group after one day of feeding. The rats in the air group were housed in room air under atmospheric pressure, and those in the hyperoxia group were placed in an atmospheric oxygen tank (oxygen concentration 85%-95%) in the same room. Eight rats each were selected from each group on days 1, 4, 7, 10, and 14, and lung tissue samples were collected. Hematoxylin and eosin staining was used to observe the pathological changes of lung tissue at different time points after air or hyperoxic exposure. Western blot and RT-qPCR were used to measure the protein and mRNA expression of HO-1 and GCLC in the lung tissue of preterm rats at different time points after air or hyperoxic exposure.@*RESULTS@#Compared with the air group, the hyperoxia group had a significant reduction in the body weight (P<0.05). Compared with the air group, the hyperoxia group had structural disorder, widening of alveolar septa, a reduction in the number of alveoli, and simplification of the alveoli on the pathological section of lung tissue. Compared with the air group, the hyperoxia group had significantly lower relative mRNA expression of HO-1 in the lung tissue on day 7 and significantly higher expression on days 10 and 14 (P<0.05). Compared with the air group, the hyperoxia group had significantly lower mRNA expression of GCLC in the lung tissue on days 1, 4, and 7 and significantly higher expression on day 10 (P<0.05). Compared with the air group, the hyperoxia group had significantly higher protein expression of HO-1 in the lung tissue on all days, and the protein expression of GCLC had same results as HO-1, except on day 1 (P<0.05).@*CONCLUSIONS@#Hyperoxia exposure may lead to growth retardation and lung developmental retardation in preterm rats. Changes in the protein and mRNA expression of HO-1 and GCLC in the lung tissue of preterm rats may be associated with the pathogenesis of hyperoxia-induced lung injury in preterm rats.

Study on Urinary Metabolic Profile in Rats with Deep Venous Thrombosis Based on Pattern Recognition / 法医学杂志

OBJECTIVES@#To study the urinary metabolic profile in rats with deep venous thrombosis （DVT） based on metabolomics and to screen out small molecular biomarkers for the diagnosis and forensic identification of DVT.@*METHODS@#Inferior vena cava of rats was ligated to construct DVT models. The rats were randomly divided into three groups： DVT, sham, and control groups, 10 in each group. The urine of DVT and sham rats was collected during 24 hours in the metabolic cage at 48 hours after operating, meanwhile, 24 hours urine was collected in control group. The metabolic profile was analyzed by nuclear magnetic resonance. SIMCA-P 14.1 software was used for pattern recognition. The variable importance in projection （VIP） value from orthogonal PLS-DA （OPLS-DA） model combined with Mann-Whitney U test were used to search the different metabolites in the urine.@*RESULTS@#The metabolic profiles of urine from DVT, sham, and control groups had significant differences. The DVT, sham, and control groups could be distinguished by the partial least squares method-discriminant analysis （PLS-DA） model. Compared with the urine of the rats in control groups, the levels of leucine, glutamine, creatine, creatinine and sucrose in the urine of DVT rats were up-regulated, and the levels of 3-hydroxybutyrate, lactate, acetone, α-oxoglutarate, citrate and hippurate were down-regulated.@*CONCLUSIONS@#The different metabolites in the urine of DVT rats are expected to become its candidate biomarkers. The results can provide a research basis for the diagnosis, treatment and forensic identification of DVT.

Data Mining-based Analysis of Regularities in Acupoint Prescriptions for Stroke Disorders in Ancient Books / 上海针灸杂志

Objective To summarize regularities in acupoint prescriptions for acupuncture treatment of stroke disorders by using data mining techniques to analyze 150 ancient acupuncture books from the Han dynasty to the end of Qing dynasty. Method A standard database and a ancient book database were established by a manual entry and proofreading method. The sentences containing stroke disorders, acupoints, meridians and needling moxibustion method in the ancient books were selected according to the key words in the standard database using a variety of data mining techniques and a regular relation to establish corresponding disease, acupoint, needling moxibustion method and meridian databases. They were classified into two types: prescriptions for stroke disorders and acupoint indications containing stroke disorders. The results from selection were reviewed manually and standardized. A multilevel analysis of regularities in acupuncture prescriptions for stroke disorders in the ancient books was performed by statistical analysis and apriori algorithm on association rules with support degree and confidence level. Result There were a total of 536 records on acupuncture point prescription for stroke disorders. Single acupoint prescriptions accounted for 34.89% of the total number of prescriptions. The single acupoint that was used most frequently was Baihui(GV20). Thedouble acupoints that were combined most frequently were Quchi(LI11) and Baihui. In three acupoint combination, Quchi and Fengshi(GB31) were separately combined most frequently with Baihui, Jianyu(LI15) and Xuanzhong(GB39). The three meridians that were used most frequently were the Du Meridian, the Large Intestine Meridian of Hand-Yangming and the Gallbladder Meridian of Foot-Shaoyang. The two meridians that were combined most frequently were the Gallbladder Meridian of Foot-Shaoyang and the Stomach Meridian of Foot-Yangming. Crossing points and Five-Shu points were selected most frequently in specific points. He-Sea points were used most frequently in Five-Shu points. Conclusion The prescriptions for stroke disorders in ancient acupuncture books focus on selecting the confluence of all yang meridians and yang meridian points. Specific points are the important composition of the prescriptions. Crossing points and He-Sea points are mainly used in specific points.

High-flow nasal cannulae and noninvasive mechanical Ventilation forthe treatment of postoperative respiratory function failure / 中国实用护理杂志

Objective To observe the high-flow nasal cannulae can reduce indoor postoperative intensive care patients with tracheal intubation in offline acute respiratory failure after extubation reintubation rates. Methods 53 cases of postoperative acute hypoxia type patients with respiratory failurein the ICU in offline after extubation were divided into two groups, control group of 24 patients, 29 cases of observation group patients. Control group patients in the event of a failure after using non-invasive mechanical ventilation (NIMV) and observation group of patients using HFNC. All other patients with same treatment and nursing. Compare two groups of patients reintubation rates. Results Observation group of reintubation rate was 20.69%(6/29), the control group was 45.83%(11/24), reintubation rate difference of two groups of patients were statistically significant (χ2=3.81, P < 0.05). Conclusions HFNC can reduce postoperative extubation after weaning reintubation rates in patients with acute respiratory failure.

Effect evaluation of preventing ventilator associated pneumoia of patients with the oral trachea can-nula by air impact method to remove airbags retentate / 中国实用护理杂志

Objective To evaluate effect of preventing ventilator associated pneumoia (VAP) of patients with oral cavity endotracheal intubation by air impulse clearing away secretion drainage. Methods 348 patients with oral trachea cannula and mechanical ventilation (MV) in intensive care unit (ICU) were divided into control group (n=174) and observational group (n=174). The control group adopted conventional airway management methods without the subglottic secretion drainage while the observational group adopted conventional airway management methods on the basis of combining air impact method remove stranded on airbags. Other treatment and care for all of patients were basically the same. The MV time, duration in ICU and incident rate on VAP were compared between the two groups. Results The average of MV time in control group was (5.25±1.18) days, (5.62±3.20) days in ICU and the rate of VAP was 10.34%(18/174). In observational, it was (8.96 ±5.43) days, (10.43 ±4.96 ) days and 34.48%(60/174), respectively. The MV time, duration in ICU and incident rate on VAP were significantly different (P<0.05), with statistical significance. Conclusions The air impact method to remove airbags retentate could shorten time of MV and during time in ICU, and could reduce the rate of VAP.

Effect of sodium houttuyfonate in enhancing imipenem's activity against Pseudomonas aeruginosa biofilms / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the resistant effect of houttuyfonate sodium (SH) combined with imipenem (IMP) against Pseudomonas aeruginosa (Pa) biofilms.</p><p><b>METHOD</b>The two-fold dilution method was used to examine the minimum inhibitory concentration (MIC) of the tested drug. The crystal violet staining was applied to detect the effect of the combination of 1/2MIC, 1MIC, 2MIC of SH, single IMP, 1/2MIC of SH and IMP of various concentrations on the clearance rate of adherent bacteria, growth of biofilms and alginate production. Fluorescein diacetate (FDA)-propidium iodide (PI) doubling staining assay was employed to observe the bacterial viability and morphological changes after membrane dispersion of each drug group.</p><p><b>RESULT</b>Sodium houttuyfonate could enhance the effect of IMP against pseudomonas aeruginosa biofilms. Particularly, the combination group with the concentration of 2MIC showed the highest effect, with P < 0.001 compared with the negative control group. The above results were proved by the bacterial viability and biofilm morphology under fluorescence microscope.</p><p><b>CONCLUSION</b>After being combined with imipenem, sodium houttuyfonate shows a higher effect against biofilms. It is expected that the combination of the two drugs could improve the clinical efficacy of associated infections.</p>

Analysis of perioperative cardiovascular events and related risk factors in patients undergoing intraperitoneal surgery / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate incidence of perioperative cardiovascular events, to analyze related risk factors for the patients undergoing intraperitoneal surgery.</p><p><b>METHODS</b>The data of 1079 patients who underwent intraperitoneal surgery (exclude laparoscope surgery) from July 2007 to June 2008 was reviewed and analyzed.</p><p><b>RESULTS</b>For the patients undergoing intraperitoneal surgery, the incidence of major cardiovascular events was 3.99% (43/1079), all-cause mortality was 1.58% (17/1079). The independent risk factors of major cardiovascular events were age ≥ 60 years, history of coronary heart disease, cardiac insufficiency, arrhythmia, chronic obstructive pulmonary disease, estimated glomerular filtration rate (eGFR) < 60 ml/(min·1.73 m(2)), emergency surgery and duration of surgery > 2.82 h (OR = 2.68 to 5.19, P = 0.001 to 0.031).</p><p><b>CONCLUSIONS</b>The cardiac risk of intraperitoneal surgery is 3.99%. The risk of cardiac complications should be evaluated in elderly patients and those with ischaemic heart disease, chronic obstructive pulmonary disease, and renal disease, more specifically, when emergent or long duration major surgeries are needed.</p>

A retrospective analysis of 97 drunk driving cases / 法医学杂志

OBJECTIVE@#Based on a retrospective analysis of the drunk driving cases, to explore the drunk drivers' personnel composition, occurrence time and psychology.@*METHODS@#As a result of punishment of the drunk driving by criminal law for one year from May 1st, 2011 to April 30th, 2012, 91 drunk driving cases were statistically analyzed the easy-happening time of drunk driving, the drunk drivers' age, gender, occupational characteristics, domicile and psychological factors.@*RESULTS@#In 97 drunk driving cases, 26-40 years old, non-local domiciled and non-professional male drivers were prone to drunk driving at night from 22:00 to 5:00.@*CONCLUSION@#The behavior of drunk driving is relevant to time, age, genders and occupation. The psychological characteristics of most drivers are fluky, making-life-easy, competitive and peacockish.

In vivo interleukin-10 gene transfer down-regulates myocardial matrix metalloproteinase and myocardial collagen expressions in rats with acute myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>We investigated the in vivo effects of recombinant adenovirus-associated virus type-2 (AAV-2) mediated interleukin-10 (IL-10) gene transfer on the expression of matrix metalloproteinase (MMP)-2, 9, tissue inhibitor of metalloproteinase (TIMP)-1, collagen type I and type III in a rat acute myocardial infarction model.</p><p><b>METHOD</b>Male Sprague-Dawley (SD) rats were randomly divided into three groups (each n = 6): sham operation group, MI/AAV2 group, and MI/AAV2-IL-10 group (10(10) vg/ml x 0.1 ml injection at peri-infarct regions immediately post MI). Five days later, the expressions of MMP-2 and MMP-9 were measured by RT-PCR, Western blot and zymography. The expression of TIMP-1 was measured by RT-PCR and Western blot. Collagen type I and type III were assessed by RT-PCR and immunohistochemical stain.</p><p><b>RESULTS</b>The myocardial expressions of MMP-2, MMP-9 and collagen contents in MI/AAV2 group were significantly increased than those in sham operation group. Myocardial expressions of MMP-2, MMP-9 were significantly decreased and the expression of TIMP-1 significantly increased in the MI/AAV2-IL-10 group than those in MI/AAV2 group. Moreover, the expressions of collagen type I, collagen type III and the ratio of I/III collagen in border zones of infarcted myocardium were decreased by 47.6% (P < 0.01), 23.6% (P < 0.05), and 17.9% (P < 0.05) respectively, while the expression of TIMP-1 increased by 73.1%(P < 0.05) in MI/AAV2-IL-10 group compared to MI/AAV2 group.</p><p><b>CONCLUSION</b>In vivo myocardial IL-10 transfer reduced myocardial MMP and collagen expression and increasing the TIMP expression.</p>

Effect of baicalin on in vivo anti-virus / 中国中药杂志

<p><b>OBJECTIVE</b>This study is about the in vivo antivirus effect of baicalin.</p><p><b>METHOD</b>Adopting in vivo experiment, we administered one group of mice 2 days before infected with influenza virus (A/FM/1/47) , while administer the other group with baicalin one day after infected, to observe the effect of baicalin in protecting and curing mice against influenza virus.</p><p><b>RESULT</b>Baicalin can obviously prolong the survival time of mice infected with influenza virus (A/FM/1/47) (P <0.01), eliminate the influenza virus in lung, reduce the hemagglutination tite and infectivity in pulmo, and reverse mice's pneumonic pathological changes.</p><p><b>CONCLUSION</b>Baicalin can obviously counteract influenza virus.</p>

Predictive value of serum inhibin B levels as an indicator of the presence of testicular spermatozoa in nonobstructive azoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the predictive value of serum inhibin B (INH B) levels as an indicator of the presence of testicular spermatozoa in nonobstructive azoospermia.</p><p><b>METHODS</b>Forty patients with nonobstructive azoospermia (NOA), 20 patients with obstructive azoospermia (OA), and 10 fertile volunteers were involved in this study. A chemoluminescence method was used to measure the levels of FSH; Inhibin B was analysed by using sandwich enzyme-linked immuno-sorbent assay.</p><p><b>RESULTS</b>Patients with nonobstructive azoospermia has significantly higher levels of serum FSH [(21.34 +/- 12.15) IU/L] and significantly lower levels of inhibin B [(53.15 +/- 58.74) ng/L] than patients with obstructive azoospermia [FSH: (3.94 +/- 1.52) IU/L, INH B: (162.49 +/- 78.38) ng/L, P < 0.01] and fertile volunteers [FSH: (4.27 +/- 2.84) IU/L, INH B: (228.49 +/- 110.68) ng/L, P < 0.01]. Mean serum inhibin B were significantly higher in patients with nonobstructive azoospermia who had spermatozoa on TESE than in those in whom no spermatozoa was found on TESE [INHB: (90.31 +/- 72.18) ng/L vs (19.54 +/- 20.38) ng/L, r = 0.528, P < 0.01], but mean FSH levels did not have similar predictive power (P > 0.05).</p><p><b>CONCLUSION</b>Serum INH B level seems to be more accurate than serum FSH in the prediction of presence of testicular spermatozoa in patients with nonobstructive azoospermia. Serum inhibin B determination may be substitute of TESE as a diagnostic index.</p>