To investigate the prognostic value of PSI, APACHEⅡ and SOFA scores in patients with hospital-acquired pneumonia and the effect of age on the efficacy of SOFA score.

The data of 80 patients with hospital-acquired pneumonia admitted in our hospital from January 2016 to December 2017 were retrospectively analyzed. Among them, 40 had non-perioperative hospital-acquired pneumonia and 40 had perioperative hospital-acquired pneumonia. Each group was evaluated by the PSI, APACHEⅡand SOFA scores with the worst physiological parameters within 24 hours after confirmed diagnosis of hospital-acquired pneumonia. Using the survival rate after 30 days as a prognostic index, the operating characteristic curves (ROCs) of the receivers were drawn to compare the difference of the three scores. On the basis of APACHEⅡ age scores, SOFA scores were re-graded to compare the effect of SOFA scores before and after age-weighting.

ROC analysis showed that the three scores could predict the 30-day mortality of hospital-acquired pneumonia. For the 40 cases of non-perioperative hospital-acquired pneumonia, the areas under the curve (AUCs) of ROC in PSI, APACHEⅡ and SOFA were 0.75, 0.69 and 0.66, respectively. And for the 40 cases of perioperative hospital-acquired pneumonia, the AUCs in PSI, APACHEⅡ and SOFA were 0.87, 0.64 and 0.70, respectively. And for the 80 cases of hospital-acquired pneumonia, the AUCs in PSI, APACHEⅡ and SOFA were 0.80, 0.73 and 0.66, respectively. After age-weighting of the SOFA scores, the AUC of the 40 cases of non-perioperative hospital-acquired pneumonia was 0.75, the AUC of the 40 cases of perioperative hospital-acquired pneumonia was 0.75, and the AUC of the 80 cases of hospital-acquired pneumonia was 0.72.

The efficacy of PSI is better than that of APACHEⅡ and SOFA regardless of whether the patient is in surgery, and the efficacy of SOFA score is increased after age-weighting.

To study the role of cardiac magnetic resonance in the evaluation of pulmonary hypertension.

From June 2012 to October 2018, 25 patients with pulmonary hypertension who were admitted to the General Hospital of Xinjiang Military Command, Urumqi, China, and were able to tolerate the right heart floating catheter examination were selected for this study. Each patient was subjected to a right heart floating catheter examination and a heart magnetic resonance examination. The related indicators of the right heart floating catheter examination and cardiac magnetic resonance examination were measured respectively and the relevance was analyzed.

In order to eliminate the influence of individual differences on the anatomical data, the inner diameter of the pulmonary trunk, the inner diameter of the right pulmonary trunk and the thickness of the anterior wall of the right ventricle measured by magnetic resonance imaging (MRI) were compared with the transverse diameter of the right diaphragm top plane. The results of one-way analysis of variance (ANOVA) showed that there existed significant differences between the inner diameter of the pulmonary trunk/the transverse diameter of the right diaphragm top plane (MPA/T), the inner diameter of the right pulmonary trunk/the transverse diameter of the right diaphragm top plane (RAP), and the thickness of the anterior wall of the right ventricle/the transverse diameter of the right diaphragm top plane (RVW/T) between the experimental group and the control group (P<0.05). There were significant differences in the pulmonary arterial systolic pressure (PASP), the pulmonary arterial mean pressure (PAMP) and the pulmonary vascular resistance (PVR) between the experimental group and the control group (P<0.05). The correlation analysis of the anatomical indexes, MPA/T, RAP/T, RVW/T, and PASP, PAMP and PVR showed that except for RAP/T and PVR (P>0.01), the P values of the rest indicators were less than 0.01, indicating that MPA/T and RAP/T were positively correlated with PASP, PAMP and PVR, and RVW/T was positively correlated with PASP and PAMP.

The anatomical indexes, MPA/T, RAP/T, and RVW/T, obtained from cardiac magnetic resonance examination, can be used to evaluate the presence or absence of pulmonary arterial hypertension and assess the degree of pulmonary arterial hypertension, it has important clinical significance.

To assess the clinical value of STOP-Bang questionnaire (SBQ) and modified mallampati score (MM) in predicting obstructive sleep apnea (OSA).

A total of 40 cases (6 females and 34 males) hospitalized in the Respiratory Sleep Center of our hospital were enrolled in this study. All the patients were prospectively predicted for risk of OSA using SBQ and MM, and their sleep quality was monitored by polysomnography (PSG). According to the apnea-hypopnea index (AHI), the patients were divided into three groups: AHI>5/h group, AHI>15/h group, and AHI>30/h group. Then all the patients received SBQ and MM assessment. Finally, we calculated the sensitivity, specificity, positive predictive values and negative predictive values for all the patients of both scores separately and in combination.

In this study, 44 patients were screened and 40 eligible subjects were included, including 34 males (85%) and 6 females (15%). Their average age was (45.1±14.6) years, their average neck circumference was (43.5±5.9)cm, their average body mass index (BMI) was 28.87 (26.35-32.13) kg/m^2, and their average AHI was 50.6 (16.22-70.98)/h. No OSA was found in 3 cases (7.5%), mild OSA in 1 case (2.5%), moderate OSA in 6 cases (15%) and severe OSA in 30 cases (75%). The results showed that SBQ≥3 had higher sensitivities (91.89%, 91.67%, and 93.33%, respectively) in predicting OSA, but lower specificities (33.33%, 25.00%, and 20.00%, respectively) were found. The sensitivities of MM≥Ⅲ in predicting OSA were 78.39%, 80.56%, 83.33%, respectively, and the specificities were 33.33%, 50%, 40%, respectively. The sensitivity of SBQ≥3 or MM≥Ⅲ in predicting OSA was higher, but the specificity was not ideal. The specificities (66.67%, 75.00%, and 50.00%, respectively) in predicting OSA were significantly improved by the combination of the two methods, and the sensitivities (75.68%, 77.78%, and 80.00%, respectively) were only slightly reduced. Among them, only moderate and severe OSA (AHI>15/h) passed the Kappa consistency test with PSG (P<0.05).

The combination of SBQ≥3 and MM≥Ⅲ for the patients treated in our sleep center can significantly improve the specificity in predicting OSA and at the same time has good sensitivity, especially for the patients with moderate or severe OSA. It has good consistency with PSG, therefore, it can be used for OSA screening.

To investigate the relationship between TCM syndrome type and pulmonary function and CAT score in patients with chronic obstructive pulmonary disease (COPD) and provide a reference for clinical practice.

400 patients with stable obstructive pulmonary disease in outpatients and inpatients of our hospital were selected as the research object from September 2015 to September 2017. According to TCM syndromes of chronic obstructive pulmonary disease, all patients were evaluated for pulmonary function, COPD assessment test (CAT) and acute exacerbation risk assessment. The pulmonary function, CAT score and the risk of acute exacerbation in patients with different TCM syndromes were compared.

(1) The data showed that there were 105 cases of phlegm-damp lung type, 108 cases of phlegm-damp lung type, 97 cases of phlegm and blood stasis type, 90 cases of lung, kidney, qi and yin deficiency type. (2) The FEV₁/FVC and FEV1% Pred of phlegm and dampness obstructing lung, phlegm and phlegm lung, phlegm and blood stasis obstruction, lung and kidney Qi and Yin deficiency decreased in turn (P<0.05). Lung function grading showed that the type of phlegm damp lung to GOLD1 level, phlegm type lungs mainly GOLD2, phlegm and blood stasis type to GOLD3 level, lung and kidney qi and yin deficiency type to GOLD4 level. (3) The proportion of high-risk increased and low-risk decreased in turn in Phlegm blocking the lungs, phlegm and phlegm lungs, phlegm and blood stasis, lung and kidney qi and yin deficiency (P<0.05).

With the development of phlegm-damp lung type, phlegm phlegm type, phlegm-stasis lung type and lung-kidney-qi-yin deficiency type, lung function gradually decreases and CAT score increases in sequence.

To compare the efficacy and safety of peripherally inserted central catheter (PICC) and central venous catheter (CVC) in the clinical application of cancer patients by systematic evaluation of all published clinically relevant randomized controlled trials of those two catheterization methods.

The literature of randomized controlled clinical trials of PICC and CVC in cancer patients were retrieved from CNKI, WanFang Data and VIP databases. The retrieval time was from the establishment of the database to August 2018. Meta-analysis was performed using MATLAB-R2016 software after two researchers independently screened the literature, extracted data and evaluated the methodological quality of the included studies according to the inclusion and exclusion criteria.

A total of 436 articles were retrieved, and 19 articles were eventually included, involving 2 242 patients with cancer. Meta-analysis showed that the success rate of primary catheterization in the PICC group was significantly higher than that in the CVC group [RR=1.16, 95% CI (1.03-1.31), P=0.018]; the indwelling time in the PICC group was significantly longer than that in the CVC group [MD=87.98, 95% CI (54.64-121.33), P<0.01]; the catheter shedding rate in the PICC group was significantly lower than that in the CVC group [RR=0.21, 95% CI (0.12-0.37), P<0.01]. The catheter infection rate in the PICC group was significantly lower than that in the CVC group [RR=0.23, 95% CI (0.15-0.37), P<0.01]; the incidence of pneumothorax in the PICC group was significantly lower than that in the CVC group [RR=0.16, 95% CI (0.06-0.46), P<0.01]; the incidence of mistakenly entering arteries in the PICC group was significantly lower than that in the CVC group [RR=0.17, 95% CI (0.08-0.36), P=0.001]; and the incidence of phlebitis in the PICC group was significantly higher than that in the CVC group [RR=3.53, 95% CI (2.15-5.81), P<0.01]. In addition, there was no significant difference in the incidence of catheter obstruction between the two groups (P>0.05).

PICC has the characteristics of high success rate, long indwelling time and fewer complications in the clinical application of cancer patients, which can be widely used in clinical cancer patients. And the quality of all the research papers included in this study is low, the evaluation of the efficacy and safety of PICC and CVC needs to continue to increase the level of research forfurther validation analysis.

To investigate the clinical effect and safety of severe craniocerebral injury patients with tracheal intubation of dexmedetomidine sedation.

116 patients with severe craniocerebral injury were selected and randomly divided into observation group and control group. Control group (59 cases) to midazolam sedation therapy, observation group (57 cases) received dexmedetomidine sedation therapy. The target sedation time, mechanical ventilation time and the time to wake up and the incidence of adverse reactions were observed and compared between the two groups.

The target sedation time, mechanical ventilation time and the time to wake up in the observation group were (29.85 ±12.11) min, (135.15±23.67)and(84.16±10.35)min, in the control group were (35.15±10.29)min, (155.26±20.35)h and(105.16±25.17)min. There is a statistically significant difference between groups(t=6.319, 5.869 and 6.124, P<0.05). The incidence of low blood pressure, respiratory depression and delirium were 12.28%, 0 , 5.26% in the observation group and 20.34%, 15.25%, 22.03% in the control group. The differences were statistically significant(χ²=4.327, χ²=7.415 and χ²=6.85, P<0.05). The incidence of of bradycardia were 14.04% in the observation group, and 3.39% in the control group. There was no statistical difference between two groups.

The application of dexmedetomidine in patients with severe craniocerebral injury of tracheal intubation can obtain satisfactory sedative sedative effect, the incidence rate of adverse reaction is lower, it is a safe and effective sedation scheme.

To study the effects of chronic disease management on pulmonary function (FEV₁, FEV₁pred %), St. George′s respiration Questionnaire score (SGRQ score) and acute exacerbation of chronic obstructive pulmonary disease (COPD).

256 cases of COPD patients diagnosed by pulmonary function were randomly selected, and then randomly divided into the Chronic Disease management Group and the Natural Course control group. After the patients were enrolled, they were divided into four groups: A, B, C and D according to the combined evaluation of GOLD 2015, and the SGRQ score was also performed. Followed up every three months, the patient's condition, drug applications were recorded in their respective medical records. Patients in chronic disease management group received six stages of COPD related knowledge training, and smokers work together to develop a smoking cessation strategy, according to the patient′s combined assessment of the group to give normative drug treatment program, guide patients rehabilitation exercise. The patients in the natural course control group only recorded the change of the condition and the application of the medicine, without intervention. Two groups of patients were administered for one year. The lung function, SGRQ score and exacerbation times of two groups of patients and four subgroups of A, B, C and D were compared and analyzed.

there was no significant difference in lung function and SGRQ score between the two groups before and after the management of chronic diseases. The number of acute exacerbations in the management group was significantly less than that in the control group. A comparative analysis of the four subgroups of patients showed that the lung function and SGRQ score of Group A were not significantly changed; The lung function and SGRQ score of the Group B and C in the management group were significantly improved, and the lung function of Group B and C in the control group was lower than before, the SGRQ score was increased, but the change was not significant, the lung function of patients in Group D decreased significantly, the SGRQ score of management group was increased, but no significant change, and the SGRQ score of the control group was significantly higher than before, there was no significant difference between the two subgroups in one years. The acute exacerbation times in Group B and C were significantly lower in management group than in control group , and in Group A and D patients, there was no significant difference between management Group and control group.

COPD patients with chronic disease management, although not significantly improve their lung function and SGRQ scores, but can reduce the number of acute exacerbations. Chronic disease management can improve the lung function, SGRQ score, reduce the symptoms, reduce the frequency of acute exacerbation and improve the quality of life in group B and group C, but have no significant influence on group A and group D.

To analysis the application of the reliability of extravascular lung water index(EVLWI) and pulmonary vascular permeability index(PVPI) in evaluating the severity of acute respiratory distress syndrome(ARDS), and to discuss the value of EVLWI and PVPI on the prognosis of ARDS.

A summary of 22 patients with ARDS in ICU of our hospital from June 2015 to December 2016, were chosed as our experimental objects. All the clinical data were collected and classified. All the patients were devided into three groups according to 2012 Berlin standard of ARDS: the mild group(n=8), the moderate group(n=6), the severe group(n=8). The levels of EVLWI, PVPI, cardiac index(CI) and intrathoracic blood volume index(ITBVI) of three groups in pre-therapy, 24 h after therapy and 72 h after therapy were measured by pulse indicator continuous cardiac output technology (PICCO) and compared. With EVLWI=13 ml/Kg and PVPI=3 as limits, the duration of hospital in ICU, mortality rate of ICU and mortality rate of 28 d after therapy of the three groups were assessed and compared in patients with different levels of EVLWI and PVPI.

In 24 h after therapy and 72 h after therapy, the levels of EVLWI, PVPI of the moderate group and severe group were significantly higher than these of the mild group, respectively, and the levels of EVLWI, PVPI of the severe group were evidently higher than these of the moderate group, P<0.05. The duration of hospital in ICU(23.6±6.6)d, mortality rate of ICU(69.2%) and mortality rate of 28 d (76.9%) after therapy of the high EVLWI group were remarkably higher than these of the low EVLWI group((15.3±5.2)d, 33.3%, 44.4%), P<0.05. The duration of hospital in ICU(24.3±6.5)d, mortality rate of ICU (57.1%) and mortality rate of 28 d (78.6%) after therapy of the high PVPI group were remarkably higher than these of the low PVPI group(16.4±4.2)d, 25.0%, 37.5%), P<0.05.

EVLWI and PVPI levels are important indicators of the severity of the disease in patients with ARDS, and high levels of EVLWI and PVPI are associated with a poor prognosis.

To analyze the effectiveness of epithelial growth factor receptor-TKIs(EGFR-TKIs) compared with chemotherapy on the clinical-selected patients.

Randomized controlled trials(RCT) evaluating the effectiveness of EGFR-TKIs compared with chemotherapy as first line treatment of the clinical-selected NSCLC were obtained from PubMed, the Cochrane library and EMBASE. All literatures were assessed by the inclusion and exclusion criteria, quality assessment and data abstraction. The Meta analysis was performed by RevMan 5.3.5 (Cochrane Collaboration) and STATA 12.0 (STATA Corp, College station, TX) software and was contrasted in EGFR TKIs-treatment of the clinical-selected NSCLC patients curative effect. The stability and reliability were evaluated by sensitivity analysis and publication bias analysis.

A total of 5 trials with 1 719 patients were included in the meta-analysis. The RR, PFS and OS of clinical-selected NSCLC patients treated with EGFR-TKIs alone or EGFR-TKIs in combination with chemotherapy as first-line therapy didn′t significantly increased compared with that of the patients treated with chemotherapy.

EGFR-TKIs therapy as first-line treatment was not suit for clinical-selected NSCLC patients.

To analyse the severity of disease and the evaluation of serum quality of life value of serumal soluble human stromelysin-2 and procalcitonin in the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

The serumal soluble human stromelysin-2, procalcitonin, C reactive protein were detected in 120 hospitalized AECOPD patients before and after the treatment, and to study the correlation above indexes with severity of COPD, COPD assessment test(CAT) and 6 minutes walk distance (6MWD).

Compared with after the treatment patients and healthy control group, serumal levels of the soluble human stromelysin-2, procalcitonin, C-reactive protein were significantly elevated in the patient with AECOPD before the treatment(P<0.05). To some extent, the levels of these indicators were increasing with the increase in the severity of the disease. The severity classification of COPD were positively correlated with serum sST2, CRP and PCT levels (r=0.588, r=0.132, r=0.305, P<0.01), serum sST2 level of the combined Class Ⅰ and Ⅱ COPD patients was significantly lower than the combined Class Ⅲ and Ⅳ COPD patients (t=9.600, P<0.01). The serumal sST2 was positively correlated with CAT (r=0.363, P<0.01), and was negatively correlated with 6MWD (r=-0.434, P<0.01).

The serumal sST2 levels in Ⅲ, Ⅳ level AECOPD patients were higher than Ⅰ, Ⅱ stage AECOPD patients, and with the condition improved, serumal sST2 decreased significantly. Serumal sST2 can reflect the severity of AECOPD patients in some extent, and has certain clinical value to evaluate the condition of AECOPD patients.

To study the correlation between chronic obstructive pulmonary disease assessment test score (CAT) and prognostic factors of chronic obstructive pulmonary disease (COPD), and explore the clinical application value of CAT in assessing the prognosis of patients with COPD.

Au 106 patients with diagnosed COPD in the department of resiratory of our hospital from January 2013 to January 2015 were enrolled in the study. The CAT score, 6-min walking distance (6MWD), modified medical British research council (mMRC), BODE index, St George′s respiratory questionnaire (SGRQ) and pulmonary function indices were collected before and after treatment. The correlation between the CAT scores and clinical characteristics were analyzed by univariate linear correlation.

With the CAT scores increased, the 6MWD, forced vital capacity (FVC) measured values, FVC observed/predicted value, forced expiratory volume in one second (FEV₁) measured values, FEV₁ observed/predicted values, FEV₁/FVC, peak expiratory flow (PEF) measured values, PEF observed/predicted values were significantly lower (P<0.05), while mMRC score, BODE index and SGRQ total score were significantly higher (P<0.05); After the short-term treatment for patients, the CAT scores, BODE index and SGRQ total scores were significantly lower than that before treatment (P<0.05), while 6MWD, FEV₁ measured values, FEV₁ observed/predicted values, FEV₁/FVC were significantly higher than that before treatment (P<0.05); The univariate analysis found that the CAT score in pre-treatment was positive correlated with mMRC scale (r=0.254, P=0.018), BODE index (r=0.426, P=0.009) and SGRQ total scores (r=0.563, P=0.007), which was negative correlated with 6MWD (r=-0.387, P=0.000), FVC measured values (r=-0.181, P=0.023), FVC observed/predicted value (r=-0.192, P=0.021), FEV₁ measured values (r=-0.201, P=0.016), FEV₁ observed/predicted values (r=-0.214, P=0.013) and FEV₁/FVC (r=-0.223, P=0.012); the CAT score in post-treatment was positive correlated with mMRC scale (r=0.304, P=0.011), BODE index (r=0.382, P=0.010) and SGRQ total scores (r=0.621, P=0.004), which was negative correlated with 6MWD (r=-0.407, P=0.000), FEV₁ measured values (r=-0.211, P=0.014), FEV₁ observed/predicted values (r=-0.228, P=0.012) and FEV₁/FVC (r=-0.231, P=0.011).

The CAT score has a good correlation with mMRC scale, BODE index, SGRQ, 6MWD and pulmonary function in COPD patients, suggesting which has a potential to predict the prognosis of COPD.