Changes of dipalmitoyl phosphatidyl choline after mechanical ventilation in patients with acute cerebral injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To detect the levels of dipalmitoyl phosphatidyl choline (DPPC) in the sputum of the patients with acute cerebral injury without primary pulmonary injury after mechanical ventilation treatment.</p><p><b>METHODS</b>DPPC levels in sputum of 35 patients with acute cerebral injury but without pulmonary injury were detected with high performance liquid chromatography at the beginning of ventilation and 16-20 days, 21-40 days, and 41-60 days after ventilation, respectively.</p><p><b>RESULTS</b>There was no significant difference of the DPPC levels between 16-20 days after ventilation (3.36+/-0.49) and at the beginning of ventilation (3.37+/-0.58) (P>0.05). The mean levels of DPPC decreased significantly at 21-40 days (2.87 mg/ml+/-0.26 mg/ml, P<0.05) and 41-60 days (1.93 mg/ml+/-0.21 mg/ml, P<0.01) after ventilation compared with that at the beginning of ventilation. At the same period, the peak inspiratory pressure and the mean pressure of airway increased significantly, whereas the static compliance and the partial pressure of oxygen in artery decreased significantly. Among the 25 patients who received ventilation for more than 20 days, 8 (32%) had slightly-decreased partial pressure of oxygen in artery compared with that at the beginning of ventilation.</p><p><b>CONCLUSIONS</b>Mechanical ventilation can decrease the DPPC levels, decrease the lung compliance and increase the airway pressure, even impair the oxygenation function in patients with acute cerebral injury. Abnormal DPPC is one of the major causes of ventilator-associated lung injury.</p>

Comparative study of pressure-control ventilation and volume-control ventilation in treating traumatic acute respiratory distress syndrome / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To observe the clinical therapeutic effect and side effect of pressure-control ventilation (PCV) on traumatic acute respiratory distress syndrome (ARDS) compared with volume-control ventilation (VCV).</p><p><b>METHODS</b>Forty patients with traumatic ARDS were hospitalized in our department from June 1996 to December 2002. Twenty were treated with PCV (PCV group) and 20 with VCV (VCV group). The changes of the peak inflating pressure and the mean pressure of the airway were observed at the very beginning of the mechanical ventilation and the following 12 and 24 hours, respectively. The transcutaneous saturation of oxygen pressure, the pressure of oxygen in artery, the mean blood pressure, the central venous pressure, the heart rate and the incidence of the pressure injury were also monitored before ventilation and 12 hours after ventilation.</p><p><b>RESULTS</b>The pressure of oxygen in artery, the transcutaneous saturation of oxygen pressure, the heart rate and the respiratory rate in the PCV group were obviously improved after ventilation treatment. The peak inflating pressure, the mean pressure of the airway and the central venous pressure in the PCV group were lower than in the VCV group. The incidence of pressure injury was 0 in the PCV group while 10% in the VCV group.</p><p><b>CONCLUSIONS</b>The clinical effect of PCV on traumatic ARDS is better and the incidence rate of pressure injury is lower than that of VCV. PCV has minimal effects on the hemodynamics.</p>

Effect of thymosin alpha 1 on cellular immune function in elderly patients with malignant tumor / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of thymosin alpha 1 on cellular immune function in the elderly patients with malignant tumor.</p><p><b>METHODS</b>Thirty patients with malignant tumor were injected with thymosin alpha 1 subcutaneously at the dose of 1.6 mg q.d. for the first month and q.o.d. for the following month. The number of T cell subgroups and the activity of NK cell in peripheral blood were detected and the quality of life of the patients were evaluated before treatment and at the end of treatment.</p><p><b>RESULT</b>Treatment of thymosin alpha 1 increased the number of CD4 cells and improved the NK activity, and also improved the quality of life of the elderly patients with malignant tumor. There were no side effects found.</p><p><b>CONCLUSION</b>Thymosin alpha 1 can enhance the cellular immune function of the elderly patients with malignant tumor.</p>

Study on anxiety and depressive disorder of inpatients in general hospital / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To assess the co-morbidity of anxiety and depression in hospitalized patients and to analyze the degree of symptoms and the influential factors.</p><p><b>METHODS</b>Thirty patients with malignant tumor were injected with thymosin alpha 1 subcutaneously at the dose of 1.6 mg q.d. for the first month and q.o.d. for the following month. The number of T cell subgroups and the activity of NK cell in peripheral blood were detected and the quality of life of the patients were evaluated before treatment and at the end of treatment.</p><p><b>RESULT</b>(1) About 39.9 % of the patients presented the symptoms of anxiety and depression and out of them 6.7 % were taken psychotropic medication. (2) Stepwise Logistic Regression showed that the factors related to anxiety and depression could be classified into four categories: economic factor, sleeping status, cognition of disease, the other factors such as course of disease and the environment of hospital. (3) Data analysis of oncology patients showed that the cognition of disease would be an important factor, which would affect anxiety and depression status.</p><p><b>CONCLUSION</b>Multiple factors can affect anxiety and depression symptoms of inpatients. The results suggest that psychological intervention such as cognitive therapy should be considered in clinical practice.</p>