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Objective To research the intervention effect of the ABCDE Bundle in mechanically ventilated patients. Methods A prospective randomized controlled trail (RCT) was selected 84 mechanically ventilated patients aged 22-45 years in the ICU of respiratory and severe medical center of the affiliated hospital of Logistics University of PAP from January to December in 2016. The research samples were randomly divided into intervention group (n=42) and control group (n=42). Samples were chosen to compare the difference of basic situation, ICU length of stay, 28-day hospital survival rate and the incidence of delirium between the patients of intervention group and control group. Results The average ICU hospitalization time in the intervention group was (11.76± 5.15) days, while that in the control group was (17.64 ± 8.04) days, and the difference between the 2 groups was statistically significant (t=3.99, P<0.01). The 4-week survival rate and delirium incidence rate in intervention group were 90.48％ (38/42) and 66.67％ (28/42) respectively, while those in control group were 71.43％ (30/42) and 40.48％ (17/42) respectively, and the difference between 2 groups was statistically significant (χ2=4.94, 5.79, P<0.05). Conclusion The application of bundles of care strategy could reduce the incidence of delirium and improve the clinical outcome of mechanically ventilated patients.
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Objective To study associations between manganese superoxide dismutase 9 Ala/Val (Mn-SOD 9 Ala/Val)genet-ic polymorphism and total superoxide dismutase (T-SOD)and Mn-SOD activity and the impact on coronary heart disease (CHD)were studied.Methods There were 82 CHD patients and 57 controls in this research.Sequencer was used to identify the genotype of Mn-SOD 9 Ala/Val genetic polymorphism and colorimeter was used to detect the serum T-SOD and Mn-SOD activity.Results Compared with the control group,the serum T-SOD and Mn-SOD activity of the CHD group was significantly reduced(t=4.83,6.57,P all<0.05),while the VV genotype and V allele of Mn-SOD 9 Ala/Val genetic poly-morphism of the CHD group were higher (χ2 =4.75,P <0.05).The serum T-SOD and Mn-SOD activity of the Mn-SOD 9 VV genotype was significantly lower than the Mn-SOD 9 AA genotype(t=2.96,3.11,P all<0.05).Conclusion The ser-um T-SOD and Mn-SOD activity in the CHD patients was reduced.Mn-SOD 9 Ala/Val genetic polymorphism was involved in the pathogenesis of CHD by influencing the Mn-SOD activity.
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<p><b>OBJECTIVE</b>To investigate the efficacy and safety of PAD [bortezomib (PS-341), doxorubicin and dexamethasone] regimen for relapsed or refractory multiple myeloma (MM).</p><p><b>METHODS</b>Seventeen patients with relapsed or refractory MM received two to four 21-day cycles of PAD: an intravenous bolus of bortezomib (1.3 mg/m2) on days 1, 4, 8, and 11; doxorubicin 10 mg per day on days 1 to 4, and dexamethasone 40 mg on days 1-4. Response was evaluated according to International Myeloma Working Group Criteria (IMWG 2006), toxicity was graded according to NCI CTCAE (common terminology criteria for adverse events) v 3.0.</p><p><b>RESULTS</b>After 2-4 courses of PAD, 14 patients (82.4%) response, including complete response (CR) in 4 (23.5%), very good partial response (VGPR) in 4 (23.5%), partial response (PR) in 6 (35.3%) and stable disease (SD) in 3 (17.6%). Median time to progression was 9.5 months. The median course to response was 1.6 (1-3). All of 5 patients with extramedullary plasmacytoma achieved at least PR after the first cycle therapy; the plasmacytoma disappeared after 1-2 cycles of PAD. The efficacy was independent of other prognostic factors such as beta2-MG. Adverse events included thrombocytopenia in 9 patients (52.9%), leukopenia in 4 (23.5%), peripheral neuropathy in 4 (23.5%), varicella herpes zoster in 3 (17.6%), fatigue in 6 (35.3%) and diarrhea in 2 (11.7%). All of these adverse reactions could be controlled with routine supportive treatment, only one patient died from respiratory failure during his fifth PAD cycle.</p><p><b>CONCLUSIONS</b>PAD regimen should be considered as an appropriate treatment for relapsed or refractory MM, especially for MM with extramedullary plasmacytoma. Its efficacy is independent of traditional prognostic factors. The side effects are usually manageable.</p>