Objective There are two main functions of gastrointestinal tract,digestion and absorption,and barrier function.The latter has an important defensive effect,which keeps the body away from the invading and damaging of bacteria and endotoxin.It maintains the systemic homeostasis.Intestinal dysfunction would happen when body suffers from diseases or harmful stimulations.The more serious intestinal disorders would harm the intestinal protective mechanism,or intestinal barrier function,and bacterial/endotoxin translocation,of intestinal failure(IF) would ensue.This article provides a critical review of the evidence indicating that an increase in bacterial translocation is associated with sepsis,and even the multiple organ failure syndrome in critically ill patients.The in-transit microorganisms play an essential role in the homeostasis of local and systemic immunity.Methods All studies published from 2000 to June 2005 about intestinal permeability,bacterial translocation,and systemic inflammatory response syndrome were located by search of PubMed.Results Clinical and experimental studies investigating the correlation between bacterial translocation and systemic inflammatory response syndrome,associated with the damage of the gut barrier function.To keep the mucosal barrier function intact is one of the main issues in the prevention of bacterial translocation.This could be achieved by the adequate delivery of oxygen and nutrient supplementation to the gut.Enteral nutrition,probiotic can be a good choice.Conclusion With a better understanding of the bacteria-host interactions in health and the alterations induced by critical illness,new therapies that improve the environment of both may lead to better recovery rates in intensive care unit patients.

Objective To explore the relationship between osteoporosis and chronic vascular complications in elderly male patients with type 2 diabetes and to evaluate its related risk factors.Methods A retrospective study was conducted in 428 elderly type 2 diabetic patients.The bone mineral density (BMD) of lumbar spines (L2 ～L4),femoral neck,Ward's triangle were measured by dual X-ray absorptiometry,and chronic vascular complications in patients were tested.The correlation between BMD and chronic vascular complications was analyzed.Results Diabetic course was longer in osteoporosis group than in non-osteoporosis group (P＜0.05).Levels of fasting blood glucose (FBG) and postprandial blood glucose (PBG) were significantly higher in osteoporosis group than in non-osteoporosis group (P＜ 0.05).The incidences of diabetic nephropathy,diabetic retinopathy,diabetic neuropathy and hypertension were higher in osteoporosis group than in non-osteoporosis group (59.8％ vs.12.0％,41.8％ vs.22.3％,33.6％ vs.24.5％,and 35.7％ vs.26.1％,respectively,all P＜0.05).Logistic analysis showed that diabetic course,FBG and diabetic nephropathy were correlated with diabetic osteoporosis (OR =1.055,1.168,7.401,95％ CI:1.015-1.096,1.073-1.273,4.303-12.727,P=0.007,0.001,0.001).Conclusions Osteoporosis has a close relationship with diabetic microvascular complications in elderly diabetic patients.Diabetic nephropathy plays an important role in the development of diabetic osteoporosis.It is helpful for osteoporosis prevention to early monitor and intervene on microvascular complications index such as urinary albumin in elderly patients with type 2 diabetes.

AIM: To find the role of heat shock protein 90(HSP90) and tubulin in oxidative stress preconditioning in HepG2 cells.METHODS: The different doses of H2O2 were used to induce cell injury in HepG2 cells.MTT assay,Western blotting and confocal laser microscopy were also used.RESULTS: MTT colorimetry showed that preconditioning(50 mmo1/L H2O2) provided a temporary resistance against subsequent oxidative stress(500 mmol/L H2O2).Western blotting demonstrated that preconditioning increased the levels of HSP90 and tubulin in HepG2 cells,and lessen the declining of HSP90 and tubulin after stress.Tubulin and HSP90's colocalizations in cells with different doses of H2O2 were also observed under laser scanning confocal microscope.CONCLUSION: Tubulin might play important role in oxidative stress preconditioning in HepG2 cells by combining with HSP90.

Brain Diseases ; etiology ; therapy ; Heat Stroke ; complications ; therapy ; Humans ; Hyperbaric Oxygenation ; Male ; Middle Aged ; Occupational Diseases ; complications ; therapy

Objective To observe the effect of Zhi Qing Capsule on the plaque formation of hyperlipemia rabbits and to discuss its mechanism.Methods Forty-eight New-Zealand rabbits were randomly divided into normal control group,hyperlipemia group,Xuezhikang control group and three Zhi Qing capsule groups.Before and after 2-week treatment,the serum levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) in the serum were determined.After 4-week treatment,TC and TG contents in the liver,and nitric oxide(NO),thromboxan B2(TXB2) and endothelin-1(ET-1) levels in the serum were measured.At the end of the sixth week,all rabbits were killed to observe aorta pathological changes.Results Zhi Qing Capsule can obviously counteract the increase of serum TC,LDL-C and liver TC in the hyperlipemia rabbits,restrain the formation of aorta atherosclerotic plaques,increase the level of NO and decrease the levels of TXB2 and ET-1.Conclusion Zhi Qing Capsule has an evident effect on resisting the lipid metabolism disturbance and atherosclerosis.

Objective To analyze the expressions and clinical significance of human epidermal growth factor receptor-2 (C-erbB-2) protein in sinonasal squamous cell cancer cells.Method Immunohistochemical and RT-PCR methods were used to detect the expression of C-erbB-2 in 62 cases of sinonasal squamous carcinoma tissues,30 cases of nasal polyps and 25 cases with normal nasal mucosa.The relationships between the expression of C-erbB-2 in sinonasal squamous carcinoma tissues and clinical pathological characteristics were analyzed.Results There was significant difference in the expression of C-erbB-2 in sinonasal squamous carcinoma tissues, nasal polyps and normal nasal mucosa tissues(P <0.05).The expression of C-erbB-2 was positively correlated with the clinicopathologic stage, tumor classification and lymph node involvement(P<0.05).Conclusion The expression of C-erbB-2 is correlated with tumorigenesis,invasion and metastasis of sinonasal squamous cell carcinoma.It can be used as an auxiliary diagnostic and prediction maker as well as a new therapeutic target of sinonasal squamous cell cancer.

Objective To investigate the characteristics and treatment effects in patients with spinal fractures associated with dural tears.Methods A retrospective analysis was made on 185 patients with spinal fractures presenting to hospital from February 2013 to February 2015.There were 103 males and 82 females,aged 17-73 years (mean,58 years).Causes of injury were high falls in 72 patients,traffic collisions in 58,hitting by heavy objects in 41,ground-level falls in 12,and collision events in two.Cervical spine fractures were seen in 65 patients,thoracic vertebra fractures in 51,and lumbosacral vertebral fractures 69.Neurologic deficit was assessed using the American Spinal Injury Association (ASIA) score,including grade A in 24 patients,grade B in 22,grade C in 26,grade D in 37 and grade E in 76.Eighty patients were managed by simply anterior surgery,97 by posterior surgery,and eight by anterior-posterior surgery.Twenty-one patients were found with dural tears (group A) and 164 patients without dural tears (group B).Incidence of dural tears in cervical,thoracic and lumbosacral vertebral fractures were recorded and compared.Preoperative neurologic deficit,laminar fracture and spinal canal encroachment rate were compared between groups.Neurological function and complications associated with dural repair were detected.Results In group A,ten patients were rated ASIA grade A,five grade B,three grade C,one grade D and two grade E.In group B,14 patients were rated ASIA grade A,17 grade B,23 grade C,36 grade D and 74 grade E.Group A accounted for 11％ (7/65) of cervical,10％ (5/51) of thoracic,and 13％ (9/69) of lumbosacral spine fractures (P ＞ 0.05).Nineteen patients (91％) in group A were complicated with neurological deficit,compared to ninety patients (54.9％) in group B (P ＜ 0.01).Eighteen patients (86％) in group A had laminar fractures,compared to fifteen patients (9.1％) in group B (P ＜ 0.01).In group A,rate of spinal canal encroachment was (62.3 ± 12.1)％ and 17 patients (81％) showed spinal canal encroachment of greater than 50％.While in group B,rate of spinal canal encroachment was (36.2 ± 15.6)％ and 25 patients (15.2％) showed spinal canal encroachment of greater than 50％ (P ＜ 0.01).For dural tears in group A,11 patients were treated by direct suturing,four by thoracolumbar fascia repair,three by artificial dural coverage and three by fibrin glue sealing.In group A,19 patients were followed up and one of them presented persistent cerebral spinal fluid leak that necessitated an irrigation and debridement to cure.ASIA score was improved from grade A to B in two patients,grade B to C in one,grade C to D in one and grade D to E in one at the final follow-up.Conclusions Majority patients with spinal fractures associated with dural tears exist severe neurologic deficit,spinal canal encroachment and laminar fractures.Incidence of dural tear in cervical,thoracic and lumbosacral vertebral fractures is similar.Incidence of complications related to dural tear repair is low,but the neurological function recovery is poor after operation.

Objective To summarize the efficacy of cervical pedicle screw fixation in the treatment of cervical spinal cord injury without fracture and dislocation.Methods From September 2007 to March 2010,21 patients with cervical spinal cord injury without fracture and dislocation combined with developmental cervical stenosis were managed by pedicle screw fixation in unstable segments,and then single open-door laminoplasty in stenosis segments.The clinical outcomes were reviewed and summarized.Results All the patients received follow-up of 1-3 years.Two patients had superficial wound infection,which was cured by dressing change.One presented intra-incisional hematoma one week post-operatively and was cured by hemostasis and drainage.One had door-reclosing without symptom aggravation.There was neither perforation of pedicle screws nor breakage,loosening or displacement of internal fixation.The curvature of cervical lordosis at follow-up had significant rectification in comparison with that at preoperation,but showed unobvious change as compared with that immediately after operation.According to the modified Japanese Orthopedic Association (JOA) score,the neurological score improved from preoperative 4-15 points to 9-17 points at the final follow-up,which revealed more than 80％ of recovery in 13 patients,50％ -80％ of recovery in six and 5％ -50％ of recovery in two,with the average recovery rate of 75％.Conclusion For unstable segments in patients with cervical spinal cord injury without fracture and dislocation combined with developmental spinal stenosis,posterior pedicle screw fixation can avoid the risk of further spinal cord injury in single open-door laminoplasty and restore the physiological curvature of cervical vertebrae,which provides solid foundation for backward drift of spinal cord and creates favorable condition for recovery of spinal cord function.

Objective To compare the efficacy and safety of thrombolysis and anticoagulant therapy for post-traumatic acute submassive pulmonary embolism (PE) in middle-aged and elderly patients.Methods Totally 45 patients with post-traumatic acute submassive pulmonary embolism in our hospital were selected.Patients were divided into thrombolysis group (n =22) and anticoagulation group (n=23) according to their conditions.Symptoms and signs,blood gas analysis,D-dimer,echocardiography,CT pulmonary angiography (CTPA) were performed before and after thrombolysis or anticoagulant therapy.Results There were no significant differences in clinical curative rate between thrombolysis group and anticoagulation group [95.5％ (21/22) vs.91.3％ (21/23),x2 =0.32,P＞0.05],and no case was found dead in both two groups.There was a significant difference in hemorrhage rate between thrombolysis group and anticoagulation group [27.3％ vs.4.3％,x2 =4.53,P ＜ 0.05].At 24 hours after thrombolysis or anticoagulant therapy,the improvement rate of dyspnea,PaO2 level was significantly higher and the pulmonary arterial pressure was significantly lower in thrombolysis group than in anticoagulation group [45.5％ (10/22) vs.17.4％ (4/23),(80.4±8.1) mm Hg vs.(73.6±9.3) mm Hg,(51.2±6.2) mm Hgvs.(60.3±5.7) mm Hg,respectively,all P＜0.05],and there were no statistical significances at other time points between the two groups.Conclusions The clinical curative rate and fatality rate are similar in thrombolysis group versus anticoagulation group.Hemorrhage rate is higher in thrombolysis group than in anticoagulation group.Thrombolysis can relieve dyspnea rapidly,reduce pulmonary artery pressure and make the embolized blood vessels recanalized.Patients with low bleeding risk in a critical condition are suggested to take thrombolysis therapy,while patients with high bleeding risk in a light condition are suggested to take anticoagulant therapy.