To investigate the expression of HMGB1 in non - small cell lung cancer and to analyze the correlation between HMGB1 and clinicopathologic outcomes. Methods:The serum HMGB1 levels in 30 patients with non - smal cell lung cancer and 15 healthy controls were determined by real time PCR and Western - blot and analys-ize their relationship with clinical pathology parameter. Results:The expression of HMGB1 mRNA and protein was significantly higher in non - small cell lung cancer group than in healthy control group. Furthermore,expression of HMGB1 protein in non - smal cell lung cancer were related to TNM staing(P ﹤ 0. 05)and lung cancer cell differenti-ation(P ﹤ 0. 05),but not to smoking,sex and histological type(P ﹥ 0. 05). Multiple comparisons showed that there were different expressions of HMGB1 with different differentiation,(0. 43 ± 0. 10),(0. 75 ± 0. 31),(0. 98 ± 0. 24) (P ﹤ 0. 05). HMGB1 protein of stage Ⅰ - Ⅱ(0. 62 ± 0. 29)were significantly higher than those of stage Ⅲ - Ⅳ(0. 85 ± 0. 32)(P ﹤ 0. 05). Conclusion:HMGB1 may be a useful clinical marker for evaluating the NSCLC progres-sion and is of potential prognostic value.

Objective Toevaluatetheclinicalvalueoffractionalexhalednitricoxide(FeNO)in predictingtheefficacyofpulmicortrespulesintreatmentofchroniccough.Methods Sixtychroniccoughpa-tients with negative results in bronchial provocation and dilation tests,induced sputum eosinophil count <3%and elevated levels of FeNO were randomly divided into the treatment (n=30)and control groups (n=30).In the control group,roxithromycin and mucosolvan were used for treatment. In the treatment group,pulmicort respulesinhalationwasperformedadditionally,2mgforeachtestfortwicedaily.Results Afteroneweek treatment,the remission rate and overall efficacy in the treatment group were significantly higher compared with those in the control group (both P<0.01 ). FeNO level in the treatment group was significantly decreased (P<0.01)whereastheFeNOlevelinthecontrolgroupdidnotdiffer(P>0.05).Conclusion FeNOplaysa role in selecting medication therapy for patients with chronic cough. Pulmicort respules inhalation is effective in treatment of chronic cough with elevated levels of FeNO.

Castleman病属原因未明的反应性淋巴结疾病之一,临床较为少见.其病理特征为明显的淋巴滤泡、血管及浆细胞呈不同程度的增生,临床上以深部或浅表淋巴结显著肿大为特点,部分病例可伴全身症状和/或多系统损害,多数病例手术切除肿大的淋巴结后,效果良好.本研究报道1例Castleman病,并对该病的病理特征、临床表现、诊断及鉴别诊断、治疗及预后进行复习.

Objective To evaluate the efficacy and safety of Olprinone in treatment of congestive heart failure(CHF).Methods 94 cases of CHF were randomly divided into Olprinone group and Milrinone group,47 cases in each group.Olprinone or Milrinone were prescribed for patients of two groups respectively.The change of NT-proBNP level,cardiac function measured by echocardiography including left ventricular ejection fraction(LVEF),fractional shortening(FS),left ventricular end diastolic diameter(LVEDD),left ventricular end diastolic volume(LVEDV),left ventricular end systolic diameter(LVESD),left ventricular end systolic volume(LVESV),cardiac output(CO) and cardiac index(CI) after 7 days' treatment and short-term prognosis were observed.Results NT-proBNP level,LVEDV of two groups decreased significantly(P =0.000,0.013 respectively in Olprinone group,P =0.000,0.014 respectively in Milrinone group),and LVEF and FS increased significantly(P =0.000,0.011 respectively in Olprinone group,P =0.030,0.042 respectively in Milrinone group).After 7 days' treatment,compared with Milrinone group,NT-proBNP level of Olprinone group was lower (P =0.041),and LVEF and FS were higher(P =0.048,0.047 respectively).There were no significant differences between PLT level,liver function and renal function of the two groups.The mortality of 7-day and 30-day of Olprinone group was not significantly different from that of Milrinone group.Conclusions Olprinone is better than Milrinone in the effect of depressing NT-proBNP level and improving cardiac function.Meanwhile,the incidence of side effect does not appear to be higher.

目的 评价无创正压机械通气(NPPV)在治疗急性左心衰时,对患者N端前体脑钠肽(NT-proBNP)与白介素6(IL-6)的影响.方法 采用随机分组的方法,将91例急性左心衰患者分为NPPV组和对照组,分别为45例和46例,观察治疗24h后血清NT-proBNP、IL-6与血流动力学、氧动力学参数的变化.结果 治疗24h后,NPPV组患者的NT-proBNP、IL-6、中心静脉压(CVP)水平均较治疗前明显降低(均P＜0.05),左室射血分数(LVEF)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧输送(DO2)及氧耗量(VO2)水平较治疗前明显上升(P＜0.05)；对照组患者的NT-proBNP、IL-6、CVP水平均较治疗前明显降低(均P＜0.01),PaO2、PaCO2和DO2水平较治疗前明显升高(均P＜0.01).两组间比较,NPPV组NT-proBNP、IL-6、CVP、PaO2、PaCO2、DO2及VO2改善幅度均明显大于对照组(P＜0.05).结论 适当参数的NPPV治疗,可降低急性左心衰患者MT-proBNP及IL-6水平,改善血流动力学及氧动力学.

Objective To compare the influences of different routes of nutrition on the outcome and respiratory muscle strength of elderly patients in respiratory intensive care unit (RICU). Methods Totally 147 elderly patients in RICU were equally randomized into combined nutrition group ( combinination of parenteral nutrition and enteral nutrition), total enteral nutrition (EN) group, and total parenteral nutrition (PN) group. The changes of energy metabolism, respiratory muscle strength, and short-term outcome were observed or determined.Results Plasma albumin (ALB), hemoglobin (Hb), creatinine (Cr) levels, and nitrogen balance significantly increased in all group 7 days later ( all P ＜ 0. 01 ), while blood urea nitrogen (BUN) significantly decreased ( P ＜0.01 ). The increase of ALB, Hb, Cr levels, and nitrogen balance were significantly more remarkable than that in EN group and PN group (P＜0.05 or P＜0.01). The decrease of BUN level in the combined nutrition group was significantly more remarkable than that in EN group ( P ＜ 0. 05 ). After nutritional support, the maximum inspiratory pressure in the combined nutrition group (P =0. 021 ) and EN group (P = 0. 011 ) became significantly higher, and occlusion pressure at 0.1 second inspiration level in the combined nutrition group became significantly lower ( P =0. 025). The incidences of infectious and non-infectious complications in PN group were significantly higher than those in EN group (P = 0. 002 and 0. 017, respectively) and combined nutrition group ( P = 0. 005 and 0. 004, respectively). Gastric retention was more common in EN group than that in PN group ( P = 0. 035). The weaning time,length of RICU stay, length of hospital stay and 20-day-mortality were significantly decreased in the combined nutrition group than those in the other two groups ( all P ＜ 0. 05 ). Conclusion The effectiveness of the combined application of PN and EN is superior to PN or EN alone in improving nutritional status and respiratory muscle strength as well as in improving the short-term outcome in elderly patients in RICU..

目的探讨气压治疗预防脑卒中后下肢深静脉血栓形成的效果。方法将70例脑卒中患者按入院顺序随机分成观察组与对照组各35例,两组患者在入院前双下肢均未接受早期循环驱动治疗。观察组使用气压治疗仪,结合常规治疗方法预防深静脉血栓,对照组按传统方法嘱或者家属经常按摩或者双下肢,结合常规治疗方法预防深静脉血栓。对两组患者的护理效果行对比分析。结果观察组发生下肢深静脉血栓2例,对照组发生8例,差异有统计学意义(P<0.05)。结论气压治疗的助于预防脑卒中后下肢深静脉血栓形成,值得临床推广应用。

目的:通过与65岁以下成年肺炎进行比较,研究老老年肺炎患者临床特点.方法:比较2007年1月～2009年8月收治的90岁以上老老年肺炎患者(观察组)60例及同期18～64岁肺炎患者(对照组)60例的临床特点及短期预后.结果:与对照组相比,观察组意识障碍发生率高、体温低、电解质失衡发生率高特别是低钠血症、白蛋白低、累及多个肺叶发生率高、合并基础疾病和多器官功能不全多、PaCO2高、死亡率高,P均＜0.05.结论:老老年肺炎预后较差,早期足量抗感染治疗原发病,及时适当补充营养,可在一定程度上改善老老年肺炎患者预后.

Objective To explore the efficacy and side effects of voriconazole therapy of invasive pulmonary fungal infection.Methods 92 patients received therapy with voriconazole.The symptoms and signs,laboratory test results,and bacteriological indexes were determined.The efficacy and side effects of voriconazole were assessed.Results The curative rate was 58.33% and total effective rate was 80.56%.Mycological clearance rate was 76.67%.Adverse reactions were mainly mental and psychic,including 49 (53.26%) cases of hallucination,26 (28.26%) visual disturbance,and 22 (23.91%) insomnia.2 patients had to discontinue voriconazole because of its severe reactions.The adverse reactions disappeared automatically in other patients after the completion of treatment.18 pateints died of worsening of the primary disorders.Conclusions Voriconazole is a novel antifungal agent.As a first-line medication for invasive pulmonary fungal infection,it is effective and safe.