Objective To evaluate the accuracy of point-of-care testing (POCT) for blood glucose monitoring in critically ill patients.Methods Two hundred and forty critically ill patients,of both sexes,aged 20-88 yr,with Acute Physiology and Chronic Health Evaluation Ⅱ score of 1-45,were enrolled.The venous,arterial and capillary blood samples were collected to determine the real-time blood glucose level using glucose oxidase (GOD) and glucose dehydrogenase (GDH) methods.The blood glucose level measured by central laboratory hexokinase method simultaneously was served as standard level.Error Grid analysis (EGA) and Bland-Altman analysis were used to determine accuracy and consistency,respectively.The accuracy of real-time blood glucose levels within the consistent limits was evaluated.Results 1.The results of EGA showed that 98.7 ％,98.3 ％,98.3 ％(GDH method) and 96.2％,96.6％,96.7％ (GOD method) of the difference between venous,arterial and capillary blood glucose levels measured and the standard level were located in the A and B zones,respectively,and 1.2％,1.7％,1.7％ (GDH method) and 2.9％,3.3％,3.3％ (GOD method) in the D zone.0.8％ (GOD method) of the difference between venous blood glucose levels and the standard level were located in the C zone.2.Bland-Altman analysis showed that the difference between the standard level and glucose level measured in blood samples from the vein,artery and capillary.was-0.1,-0.3,-0.2 mmol/L (GDH method) and-0.9,-1.0,-0.9 mmol/L (GOD method),respectively,and the incidence beyond the upper and lower limits of consistency zone was 4.5 ％,6.7 ％,6.6 ％ (GDH method) and 4.6 ％,5.0 ％,7.1％ (GOD method),respectively.The accuracy of venous,arterial and capillary blood glucose levels within the consistent limits was 94.3 ％,92.1％,93.7％ (GOD method) and 96.6％,95.1％,95.5％ (GDH method),respetively.Conclusion The accuracy of POCT for blood glucose monitored by GOD and GDH methods is good in critically ill patients,but it is possible to overestimate the patient's real glucose level.

OBJECTIVE:To optimize kind of safe and effective iodophor thinner.METHODS:Iodophor solutions in several different solvents were made and diluted 5,10 and 20 times,respectively.Then their microbicidal potentials on 3 standard strains were monitored.RESULTS:The standard strains were all killed within 5 min by iodophor solution in normal sodium or by low multiple diluted iodophor solution in distilled water;however,there were a few Escherichia coli and Pseudomonas aeruginosa still alive within 5 min in high multiple diluted iodophor solution in distilled water.Iodophor solution in tap water failed to kill all the standard strains,especially the Pseudomonas aeruginosa.CONCLUSION:Normal saline solution and distilled water have been proved to be the ideal iodophor thinners.

Objective There have been few research on the relationship between expression of HDAC4 and chemotherapy resistance in human lung adenocarcinoma.The present study aims to investigate the expression and clinical significance of HDAC4 in human lung adenocarcinoma tissues.Methods We selected 72 tissues in lung adenocarcinoma patients with docetaxel-resistant from January 2006 to December 2007 in Department of Oncology and Thoracic Surgery, Nanjing General Hospital of Nanjing Military Region, then evaluated the recent efficacy according to the RECIST criteria and divided the tissues into sensitive(n=32, included complete remission and partial remission) and insensitive(n=40, included stability and progress) groups.The expression of HDAC4 in tissues≥the HDAC4 optimal relative expression cut-off value(78.7) was high level HDAC4 group(n=35), otherwise it was low level HDAC4 group(n=37).QRT-PCR analysis was performed to detect the HDAC4 expression levels in sensitive group and insensitive group.Analyzed the progression free survival in high level HDAC4 group and low level HDAC4 group.Results The expression of HDAC4 was significantly higher in the insensitive group compared with the sensitive group [(1.42±0.30) vs (0.60±0.15), P<0.01].The median progression free survival was significantly shortened in the high level HDAC4 group compared with the low level HDAC4 group (10.2 months vs 5.8 months, P<0.05).ConclusionThe expression of HDAC4 increased in docetaxel-resistant lung adenocarcinoma patients, and it is expected to be a predictive indicator of the resistance of docetaxel.

OBJECTIVE:To analyze the blood concentration monitoring data of 4 commonly used antiepileptic drugs(AEDs, sodium phenytoin,carbamazepine,sodium valproic acid,oxcarbazepine)in order to provide reference for rational use of drugs in the clinic. METHODS:415 patients underwent 4 AEDs blood concentration monitoring were selected from our hospital during 2014-2015,and the results of blood concentration monitoring were analyzed statistically. RESULTS:There were 680 cases of AE-Ds blood concentration monitoring in total. The main objects of serum concentration monitoring were young and middle-aged(range from 19 to 60),involving 449 cases in total(66.03%). 360 cases were in the normal range(52.94%). Among 361 patients receiving single drug therapy,the rates of serum concentration in the normal range were 80.77%for carbamazepine,which was higher than oth-er 3 AEDs(30.00% for sodium phenytoin,47.40% for sodium valproic acid and 40.38% for oxcarbazepine),with statistical signifi-cance(P<0.05). Among 54 patients receiving combination therapy,the serum concentration monitoring data of 67.65%patients treat-ed with double-combination therapy and 100%patients treated with triple-combination therapy deviated from normal range. CONCLU-SIONS:The rate of AEDs blood concentration reaching the normal range are in low level in our hospital. It’s necessary to strengthen medication education for patients to improve the compliance of patients;clinical efficacy of AEDs is evaluated on the basis of blood concentration monitoring and clinical symptom,and combination therapy should be avoided as much as possible.

Aim To investigate the inhibitory effect of schizandrin B( SchB) on ultraviolet radiation b ( UVB) radiation-induced apoptosis of HaCaT cells. Methods Methyl thiazolyl tetrazolium ( MTT ) assay was used to examine the effect of SchB on cell viability recovery. Cell apoptosis and necrosis were measured by Ho-chest33342 staining. The p53, p21 and Caspase-3 mRNA expressions were examined by RT-PCR. Results In this study, we found that Sch B attenuated UVB-in-duced toxicity in HaCaT cells. Through Hoechst 33342 stain, we visualized that SchB could inhibit UVB-in-duced HaCaT cell death. The result demonstrated that p53 , p21 and Caspase-3 mRNA levels decreased com-pared with the control group. Conclusions Sch B at-tenuates the UVB-induced toxicity of HaCaT by inhibi-ting apoptotic gene expression. It plays a role in anti-photoaging.

Objective To evaluate the mechanism of external branch of the superior laryngeal nerve (EBSLN) injury during thyroid surgery as showed by intraoperative neuromonitoring.Methods 70 patients with 109 nerves at risk were enrolled in this study from March 2011 to October 2011.A positive signal is determined by observing contractions of the cricothyroid muscle.The relationship between EBSLN and the upper pole of the thyroid or the inferior constrictor muscle was studied.Results 108 nerves (99.1％) were located successfully,42 of which were visualized (38.9％).55 nerves (50.9％) crossed the superior thyroid artery more than 1 cm apart,while the other 53 nerves (49.1％) went less than 1 cm including 24 nerves(more than 0.5 cm,less than 1 cm) and 29 nerves (less than 0.5 cm) or coursed below the superior pole of the thyroid.The rate of the latter type was significantly elevated in patients with the top to botton diameter of the gland more than 5 cm.One patient suffered from impairing in the production of high tones postoperatively.Conclusions Intraoperative neuromonitoring is useful and helpful in providing instructive information for operations by locating EBSLN.

Objective To investigate the effect of exogenous hydrogen sulfide on myocardial NF-κB signaling pathway in rats with hemorrhagic shock (HS).Methods Forty adult male rats,weighing 250-300 g,were randomly divided into 4 groups (n =10 each):sham operation group (Sham group),sham operation + NaHS group (Sham + NaHS group),HS group and HS + NaHS group.HS was induced by withdrawing blood from the femoral artery.After HS,NaHS 28 μmol/kg was injected intraperitoneally at 10 min before resuscitation in groups HS + NaHS and Sham + NaHS.MAP was monitored and recorded at 0,1.5,2,3,4 and 6 h after blood-letting.The rats were then sacrificed and hearts were removed for determination of phosphorylated IKKβ (pIKKβ),IκBα (pIκBα),NF-κB p65 (pNF-κB p65) and high-mobility group box 1 (HMGB1) and for examination of myocardial ultrastructure with light and electron microscope.Results Compared with Sham and Sham + NaSH groups,MAP was significantly decreased and the expression of pIKKβ,pIκBα,pNF-κB p65 and HMGB1 was up-regulated in HS and HS + NaHS groups (P ＜ 0.05).Compared with HS group,MAP was significantly increased and the expression of pIKKβ,pIκBα,pNF-κB p65 and HMGB1 was down-regulated in HS + NaHS group (P ＜ 0.05).The pathologic changes were attenuated in HS + NaHS group compared with group HS.Conclusion Exogenous hydrogen sulfide can attenuate myocardial injury induced by HS through inhibition of NF-κB signaling pathway and reduction of inflammatory response.

Objective To explore the protective effect of schisandrin B (SchB) on the permanent damage of human keratinocytes (HaCat) induced by long wave ultraviolet (UVA),and its possible mechanism thereof. Methods After HaCat was treated by 5 J/cm2 UVA, different concentrations of SchB (0.1, 0.01, 0.001 and 0.000 1μmol/L) were used to treat HaCat cells. The levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activity, lactate dehydrogenase (LDH) and NO content were detected. Results The levels of SOD and GSH-Px activity were decreased, and he levels of LDH and NO content were increased in HaCat cells after being treated by UVA. The different concentrations of SchB showed significant ef-fects on the increased levels of SOD, GSH-Px activity and decreased levels of LDH and NO, and improved the survival rate of HaCat cells. The 0.001 μmol/L SchB showed the strongest protective effect. Conclusion The 0.001 μmol/L SchB showed the best effect on the damage of HaCat cells induce the UVA.

AIM: To investigate the effects of myocardial remodeling of aged left atrium (LA) on atrial ar-rhythmogenesis in rabbits .METHODS:The male New Zealand rabbits were divided into young LA and aged LA groups . By observing the changes of monophasic action potential ( MAP) and burst-pacing in LA of the rabbits in vivo, the main cardioelectrophysiological parameters such as resting membrane potential ( RMP) , action potential amplitude ( APA) , ma-ximum rise veloctiy of action potential (dv/dtmax), plateau potential and action potential duration at 30%, 50%and 90%( APD30 , APD50 and APD90 ) , as well as the inducibility and duration of atrial arrhythmias were recorded .L-type calcium current (ICa,L) was analyzed via whole-cell patch-clamp technique in enzymatically dissociated single rabbit LA myocytes . The myocardial collagen content was quantified after Masson staining , and the ultrastructure of the LA cells was observed under scanning electron microscope .The expression of Cav 1.2 in LA tissue of the 2 groups was detected by Western blot . RESULTS:Compared with young LA group , dv/dtmax and plateau potential were significantly decreased , APD30 and APD50 were shortened, and APD90 was notably prolongated in aged LA group (P<0.01).The inducibility or duration of atrial arrhythmias was severely increased or prolongated in aged LA group (P<0.01).With voltage clamp model, the den-sity of ICa,L in aged LA group was significantly decreased , and current-voltage curve was notably moved upward compared with young LA group.When the clamp potential was +20 mV, the density of ICa,L was notably modified from (11.72 ± 1.39) pA/pF in young LA group to (6.08 ±0.98) pA/pF in aged LA group ( P<0.01).Compared with young LA group, the protein level of collagen was significantly increased (P<0.01), and the arrange of atrial myocytes was irregular in LA of rabbits in aged LA group .The atrial myocytes of the LA wall in aged LA group exhibited abnormal ultrastructural alterations , such as karyopyknosis , irregular and swelling mitochondria with the presence of vacuoles , and mild and severe sarcomere degeneration .Compared with those in LA tissues of young rabbits , the expression levels of Cav 1.2 in the LA tis-sues of aged rabbits were severely reduced (P<0.01), and had a significant positive correlation with the reduction of ICa,L (r=0.83, P<0.01).CONCLUSION:The pathophysiological characteristics of aged LA are significantly altered , and might contribute to vulnerability and susceptibility of occurrence of atrial fibillation in aged rabbits .The mechanisms might completely attribute to the notable reduction of ICa,L , abnormal alterations of ultrastructures and obvious decrease in the ex-pression of Cav1.2 in the aged LA of aged rabbits .

Objective To evaluate the surgical modalities and prognosis in elderly patients with gastric cancer.Methods Sixty three gastric cancer patients aged ≥≥ 75 years underwent radical surgery,with D0 + D1 resection in 32 cases and D2 resection in 31 cases,in Beijing Hospital from January 2005 to December 2009.Results More lymph nodes were dissected in D2 group than those in D0 + D1 group (27.42 ± 12.75 vs.14.59 ± 12.11,t =-4.095,P ＜ 0.05).There was no significant difference in postoperative complication rate [25.81％ (8/31) vs.31.25％ (10/32),x2 =0.095,P ＞ 0.05] and perioperative death rate [3.23％ (1/31) vs.6.25％ (2/32),x2 =0.324,P ＞ 0.05] between two groups.The 5-year survival rate was higher in D2 group than that in D0 ± D1 group (47.3％ vs.21.4％,x2 =6.346,P ＜ 0.05).The 5-year survival rate was higher in POSSUM score (PS) ＜ 20 group than that in PS≥20 group (46.3％ vs.11.1％,x2 =5.492,P ＜0.05).In PS≥20 group,postoperative complication rate did not increase after D2 radical resection(1/8 vs.3/10,x2 =0.824,P ＞ 0.05).Univariate analysis showed that PS ＜ 20 was associated with the prognosis of patients (x2 =5.492,P ＜ 0.05).Cox proportional hazards model showed that lymph node metastasis (OR=4.103,95％ CI:1.790-9.405,P ＜ 0.05) and D2 radical gastrectomy(OR =0.313,95％ CI:0.158-0.620,P ＜ 0.05) were the independent factors associated with the prognosis of patients aged ≥ 75 years with gastric cancer (all P ＜ 0.05).Conclusion Standardized D2 lymph node dissection is beneficial for gastric cancer patients aged ≥75 years.PS ＜ 20,lymph node metastasis and D2 radical gastrectomy are associated with the prognosis of patients.