Objective To evaluate the clinical efficacy of integrated treatment ( sequential noninvasive following invasive mechanical ventilation, bronchoscope suction, combined inhalation) in patients with acute respiratory failure induced by chronic obstructive pulmonary disease ( COPD) . Methods 59 elderly patients with COPD and acute respiratory failure in ICU fromJuly 2006 to July 2009 were enrolled in the study. The patients were randomized into three groups, ie. a non-invasive mechanical ventilation group ( NIV group) , a sequential non-invasive following invasive mechanical ventilation group ( SV group) , a integrated treatment group ( IT group) . APACHEⅡ score, clinical pulmonary infection score ( CPIS) ,arterial blood gas analysis, respiratory rate ( RR) , heart rate ( HR) , and mean artery blood pressure ( MAP)at 0 h, 3 h, 3 d, 12 d after treatment were recorded. Results With the extension of treatment time,APACHEⅡ score, CPIS score, RR, HR, PaCO2 , and white blood cells gradually reduced, while pH and PaO2 gradually increased in the three groups ( P lt;0. 05) . The differences in RR, HR, PaCO2 , and PaO2 at the time of 3 d and 12 d were significant between the three groups( P lt;0. 05) . The occurrence of pulmonary infection control ( PIC) window and ventilation associated pneumonia ( VAP) had no difference among the three groups( P gt;0. 05) . The duration of total mechanical ventilation, durations of ICU stay and hospital stay were shorter in SV group than those in NIV group( P lt;0. 05) . The duration of total mechanical ventilation,duration of invasive mechanical ventilation, durations of ICU stay and hospital stay were shorter in IT group than those in SV group( P lt;0. 05) . The incidence of VAP was higher in SV group than NIV group, but lower in IT group than SV group( P lt;0. 05) . Hospital mortality was lower in SV group than NIV group, and higher in IT group than SV group( P lt; 0. 05) . Conclusion In elderly COPD patients with acute respiratory failure, integrated treatment given early can reduce the duration of mechanical ventilation, the length of ICU and hospital stay, and decrease the morbidity of VAP and mortality.
Objective To analyze the effectiveness of conservative medical treatments for ectopic pregnancy (EP): methotrexate (MTX) + mifepristone + Ectopic Pregnancy II decoction (EP-II) vs. methotrexate + mifepristone. Methods A total of 95 patients with EP in Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University from January 2009 to January 2011 were randomly divided into two groups: 45 patients in the experimental group were treated with MTX, mifepristone and EP II decoction, while the other 50 patients in the control group were treated with MTX and mifepristone. The effectiveness of the two groups was analyzed with SPSS 13.0 software. Results There were significant differences in the time of serum β-HCG return to normal (16.13±8.13 ds vs. 22.05±7.15 ds, Plt;0.05), time of EP mass absorption (30.46±7.56 ds vs. 39.99±18.26 ds, Plt;0.05) and tubal patency rate (80% vs. 75%, Plt;0.05) between the two groups. But there were no significant differences in effective rate (95.56%, 43/45 vs. 94%, 47/50, χ2=0.0809, Pgt;0.05) and side effects. Conclusion The combination of methotrexate, mifepristone and EP II decoction for ectopic pregnancy is more effective than mifepristone and methotrexate in coordinately killing the embryo, shortening the time of serum β-HCG return to normal and the time of EP mass absorption, and improving the function of oviducts.
ObjectiveTo explore the dynamic changes of immune cell populations in Panc02 pancreatic cancer bearing immunocompetent mice. MethodsThe C57BL6/J mice syngeneic pancreatic cancer cell line Panc02 were subcutaneously implanted to establish the immunocompetent murine pancreatic cancer bearing model.According to the tumor size, the tumor was classified into 4 stages, named T1-T4, respectively.The flow cytometry was performed to identify the dynamic changes of different cell populations, such as inflammatory cells (CD45+), T helper (Th) lymphocytes, cytotoxic T lymphocytes (CTL), B lymphocytes, granulocytes, macrophages, dendritic cells (DC), natural killer (NK) cells, and natural killer T (NKT) cells in the peripheral blood and tumor tissue. ResultsThree dynamic types of immune cells with the tumor progression were identified:consistent increase, consistent decrease, increase and then decrease.①In peripheral blood:The proportion of the Th lymphocytes, CTL, and B lymphocytes consistently decreased; The proportion of granulocytes consistently increased; The proportion of the DC, macrophages, NK cells, and NKT cells increased from T1 to T3 stage but sharply decreased at T4 stage.②In tumor tissue:The intratumoral CD45+ cells consis-tently increased; The proportion of the granucolyte, macrophages, and DC consistently increased; The proportion of the Th lymphocytes and the CTL consistently decreased; The proportion of the B lymphocytes did not change significantly; The proportion of the NK cells or NKT cells increased from T1 to T3 stage but sharply decreased at T4 stage. ConclusionWith pancreatic cancer progression, the immune cell populations show different dynamic change models, which imply their important roles in predicting the prognosis and the integrated treatments of pancreatic cancer.