Objective To analyze the correlation between fluid equilibrium and oxygen index in patients at early stage (within 2 weeks) of severe acutepancreatitis (SAP),and to discuss the effects of fluid equilibrium after resuscitation on the prognosis.Methods A clinical study was conducted.Ninety-seven patients with SAP admitted into Shengjing Hospital of China Medical University directly or transferred into intensive care unit (ICU) in 24 hours after admission between March 201 1 to October 2013 were studied.Finally,65 patients were enrolled in statistical analysis,and those with termination of treatment prematurely were excluded.The patients received treatment protocol formulated by the same physician in ICU.Patients were divided into improved group and death group according to the outcome.The differences in fluid equilibrium on 1,2,3,7,14 days after admission of ICU between the two groups were compared.The correlation between fluid equilibrium and oxygen index was analyzed with curve fitting.Results Among 65 patients enrolled,53 of them were improved after intensive care and were transferred into ordinary wards.However,12 patients died in ICU.Patients in the improved group showed delayed positive fluid equilibrium,and some patients even showed negative fluid equilibrium.Patients in death group needed more fluid to achieve fluid equilibrium.There was a significant difference in the need of fluid to reach an equilibrium between improved group and death group [1 day:1 814.5 (905.2,2 152.8) vs.3 891.0 (2 524.2,5 714.5),Z=-3.303,P=0.001; 2 days:2 469.0 (1 456.0,3 696.0) vs.6 498.0(4 617.8,8 763.5),Z=-4.431,P＜0.001 ; 3 days:3 234.0 (1 098.0,4 295.5) vs.9 533.5 (6 748.8,10 689.0),Z=-4.684,P＜0.001 ; 7 days:3 234.0 (1 033.0,5 162.0) vs.13 986.5 (8 045.8,14 518.0),Z=-4.718,P＜0.001 ; 14 days:3 234.0 (978.5,4 924.0) vs.13 436.5 (8 045.8,14 518.0),Z=-4.769,P＜0.001].There was no correlation between fluid equilibrium and oxygen index in improved patients within 3 days of ICU admission (R 2=0.000,P=0.827),and it fit the logistic curve in a relatively low level after 3 days of ICU admission (R 2=0.036,P＜0.001).Conclusions Early fluid resuscitation could help maintain hemodynamics stability in SAP patients.Those SAP patients who showed a negative equilibrium in early stage showed a better prognosis,and the fluid equilibrium and oxygen index in improved patients fit the logistic curve after 3 days of ICU admission.

Objective To explore the effect of non-directed musical therapy on the automatic thoughts and therapeutic effect of depression.Methods 60 people outpatient and inpatient who with depression disorder participated in this research.According to the medical order,we choose the people who with Cardinality order as the group of the musical therapy (study group) and the people with the even order as the group of drug therapy (control group).all the patients was test with the Hamilton's Depression Scale (HAMD-24) and Automatic Thoughts Questionnaire (ATQ) before and after 2,4,8 weeks treatment,and comparison of these questionnaires scores of the two groups.Results After the 2,4,8 weeks treatment,the HAMD scores of the study group was (15.70±2.63),(10.03±2.28),(6.00± 1.98) and the scores of control group was (17.43±2.62),(12.47±2.75),(7.50±2.03).The result of HAMD scores had significant difference(F=11.754,P=0.001).ATQ scores of the study group was (73.27± 17.60),(58.33± 13.66),(47.43± 11.94) and the scores of control group was(84.20±22.30),(72.53±20.86),(58.90± 18.61).The result of ATQ scores had significant difference(F=4.136,P=0.047).Conclusion Non-directive musical imagery could be an effective way to improve the automatic thoughts of people who with depression disorder and improve the effect of treatment.

ObjectiveTo systemically review the effects of timing of initiation of renal replacement therapy (RRT) on prognosis in septic patients with acute kidney injury (AKI).Methods A systematic search for randomized controlled trials (RCTs) and other clinical studies focused on comparing varied timing of initiation of RRT in septic AKI patients was performed in English or Chinese from PubMed, Web of Science, EMBASE, CNKI, Wanfang data, VIP from January 2000 to July 2014. Data screened were extracted with Cochrane systemically review method, and enrolled literature was collected for Meta analysis with RevMan 5.2 software. Total mortality, 28-day mortality, the total length of hospital stay and intensive care unit (ICU) stay in septic AKI patients with early or late initiation of RRT was analyzed. Funnel plots were drawn to detect publication bias.Results Five retrospective comparative studies with a total of 885 patients were enrolled. Random effect model in Meta analysis showed that there was no significant difference in total mortality between early RRT group and late RRT group [65.7% (226/344) vs. 68.7% (239/348), odds ratio (OR) = 0.71, 95% confidence interval (95%CI) = 0.38-1.31,P = 0.27]. The funnel plot demonstrated publication bias. Fixed effect model showed that there was significant difference in 28-day mortality between early RRT group and late RRT group [43.4% (66/152) vs. 55.3% (94/170),OR = 0.59, 95%CI = 0.36-0.94,P= 0.03]. The funnel plot demonstrated publication bias too. The data of total length of hospital stay and ICU stay could not be Meta-analyzed because of different data distribution, but no differences in total length of hospital stay and ICU stay between early and late RRT groups for septic AKI patients were found.ConclusionEarly RRT could reduce the 28-day mortality in patients with septic AKI compared with late RRT, but it did not lower the total mortality.

Objective To study the correlation of NF-?B expression with the grade, the stage, the recurrence, the metastasis and PKC expression of bladder transitional cell carcinoma. Methods The expression of NF-?B and PKC was examined with SP immunohistochemical method in 54 cases of paraffin-embedded bladder transitional cell carcinomas tissues and 13 cases of normal bladder tissues. Results The positive expression rate of NF-?B P65 and PKC in bladder transitional cell carcinomas was 88 9% and 81 5% respectively. The expression rate of NF-?B decreased along with pathological grade and clinical stage increased, while its expression increased along with the rate of recurrence and metastasis elevated. There was a positive relationship between NF-?B and PKC expressions. Conclussion NF-?B may play a role at early stage of bladder transitional cell carcinoma. It probably serves as an index to evaluate the malignant extent and progression of bladder transitional cell carcinoma. PKC probably takes part in the activation process of NF-?B.

Bl on the 21st day of gestation. The difference was statistically significant ( P

BACKGROUND: Xiongbitong capsule (capsule) increases blood flow in myocardial ischemic area in patients with coronary heart disease, lessens the size of myocardial infarction and improves ischemic S-T alternation in electrocardiogram (ECG).OBJECTIVE: To observe the effect of the capsule on NO metabolism on arterial wall in rabbits and explore the improvement of such drug on myocardial blood flow and protection on myocardium.DESIGN: Randomized group division and control experiment were designed.SETTING: Department of First Internal Medicine, Hospital of Traditional Chinese Medicine, Weifang, Shandong.MATERIALS: The experiment was performed in Teaching-Research Room of Physiology of Weifang Medical College from April 2003 to February 2004. Totally 30 healthy adult rabbits were employed, of either sex and randomized into 3 groups, named normal control, model group and treatment group, 3 rabbits in each one.METHODS: ① Preparation of hyperlipemia (HP) model: In normal control, common granular forage was used. In model group, modeling forage was applied (common granular forage + 3% pig oil + 1% cholesterol powder). In treatment group, besides modeling forage, at the end of the 6th week, the capsule [composed of taizishen (Radix Pseudstellariae), yunling (Poria), gualou (Frnctus Trichosanthis), qingxia (Rhizoma Pinelliae), juhong (Exocarpium Citri Grandis), shichangpu (Rhizoma Acori Graminei), yujin (Radix Curcumaea), zhifuhua (Flos Inulae), jiangxiang (Lignum Dalbergiae Odoriferae), danggui (Radix Angelicae Sinensis), maidong (Radix Liriopis Platyphyllae) and wuweizi (Frnctus Schisandrae).] was administrated every day for gastric perfusion at 1 pill/kg with 10 mL physiological saline for 3 weeks. The intervention was applied totally for 8 weeks. ② Nitrieoxide synthase (NOS) and NO metabolic product kits were provided from Radiation Medical Institute of Military Academy of Medical Sciences. The operation was based on the instrnction. NOS activity was calculated and expressed by NO amount (nmol) produced in one-gram tissue per minutes.Spectrophotometer was used to measure the optic density of sample at 545nm. Sodium nitrite solution was used to prepare standard curve. The concentration of serum NO metabolic products, NO2- and NO3- was expressed with μmol/L. ③ T test was applied for difference comparison among measurement data.MAIN OUTCOME MEASURES: Comparison of NOS activity and concentration of serum NO metabolic products in vessel-wall tissue in eachgroup.RESULTS: Totally 30 rabbits all entered result analysis. For NOS activity and concentration of serum NO metabolic products in arterial-wall tissue,the results in model group and treatment group were lower remarkably than the control (P ＜ 0.05-0.01) and the results in treatment group were higher remarkably than model group (P ＜ 0.05).CONCLUSION: ① NO system of arterial wall is damaged in HP rabbits and NO metabolic level is decreased in serum. ② Xiongbitong capsule improves the above situation and brings the resistance of myocardial ischemia and protection of myocardium into play.

Objective:To study the optimum extraction conditions for Yaotong granules. Methods:An orthogonal test was adopted to optimize the percolation extraction process of total alkaloids by orthogonal experiment with the yield of dry extract and total extraction rate of tetrandrine and fangchinoline as the indices. Results:The optimal extraction conditions were as follows:the medicinal materials were soaked with crude powder in 60% ethanol for 48h,then percolated at the rate of 2 ml·min-1 ·kg-1 . Conclusion:The extraction technology for Yaotong granules is simple and rapid with stable results,which can provide theoretical basis for the production of Yaotong granules.

Objective To explore the effect of Valpar occupational assessment training system on cognitive dysfunction in schizophrenia. Methods Sixty patients with schizophrenia were randomly assigned into Valpar therapy group ( experiment group, n=30) and traditional rehabilitation therapy group ( control group, n=30) according to the order number. The duration of the treatment was six weeks. The brief assess?ment of cognition in schizophrenia ( BACS) and Wisconsin card sorting test ( WCST) were conducted as pre?and post?treatment assessment. Results There were significant differences between scores of BASC in pre?and post?treatment assessment in experiment group. More specifically, the BASC scores in symbol coding (37.50±6.50, t=-4.60, P<0.01),token movement(60.80±8.72, t=-2.54, P=0.017),verbal memory (44.40±11.29, t=-2.19, P=0.037)),and word fluency(14.23±4.35, t=-3.39, P=0.002) were signifi?cantly different when comparing pre?and post?treatment assessment outcomes. In control group,the only sig?nificant difference was found in word fluency (14.23±4.35, t=-3.39, P=0.002).In addition,response errors (57.80±10.35, t=-3.06, P=0.005) and repeat errors (34.67±6.96, t=3.41, P=0.002) in WCST in exper?iment group were significantly different in pre?and post?treatment assessment while only repeat errors (34.30 ±7.01, t=4.36, P=0.000) was different in control group. It was further discovered that scores in in symbol cod?ing( t=2.010, P=0.048),token movement ( t=2.124, P=0.038),response errors ( t=2.413, P=0.020) and repeat errors( t=2.009, P=0.047) in WCST were different between two groups. Conclusion Valpar professional evaluation train?ing system can significantly improve the cognitive function of people with schizophrenia.

Objective To assess on the effect of the different catheterization on patients with oral poisoning gastric lavage systematically and objectively. Methods A computerized search of PubMed, the Cochrane Library, EMBASE, Springer Link, Science Direct,China Biology Medicine (CBM),China National Knowledge Internet(CNKI), Wanfang Data and VIP database was performed for relevant randomized controlled trials (RCTs) which investigated the effects of the oral intubation gastric lavage on patients with oral poisoning relative to nasogastric lavage, retrieval to January 2016, and back into the study of references. According to include and exclude standard to screening literature, literature which met inclusion criteria was selected for quality evaluation and data extraction. Meta-analysis and trial sequential analysis were performed by using Rev-Man 5.3 and TSA soft-ware to estimate the required information size (RIS). Results 13 studies incorporated into Meta-analysis including a total o 1 296 patients. Meta-analysis results showed that the oral intubation gastric lavage group was better than nasogastric lavage in shortening the time of intubation [MD=-9.05, 95% CI(-12.86--5.23), P=0.00], improving the rate of intubation for the first time [MD=1.36, 95% CI (1.14-1.62), P =0.00], mucosal bleeding complication [MD=0.11, 95% CI (0.04-0.64), P=0.010], nausea and vomiting [MD=0.60, 95%CI (0.37-0.98), P=0.04], kinking [MD=0.14, 95% CI (0.02-0.80), P=0.03], reflex cardiac arrest [MD=0.24, 95% CI (0.08-0.71), P=0.01] and asphyxia [MD=0.45, 95% CI (0.26-0.80), P=0.007], the difference were statistically significant. But no significant difference existed in gastric tube fall off. Conclusions The oral intubation gastric lavage could shorten intubation time of patients, improve the first time intubation rate and reduce certain complications. It suggests that the oral intubation be extensively applied to care patients with oral poisoning.

Objective To investigate the protective effect of autophagy inducer rapamycin on acute kidney injury (AKI) induced by sepsis. Methods Twenty-four Sprague-Dawley (SD) male rats were randomly divided into sham group, caecal ligation and puncture (CLP) model group, and rapamycin treatment group (Rap treatment group), with 8 rats in each group. The septic AKI model was reproduced by CLP in rats, and rats in sham group were given appendix isolation without ligation and puncture. The rats in Rap treatment group were given 1.6 mg rapamycin by intraperitoneal injection immediately after model reproduction, and the rats in CLP model group were injected with an equal amount of normal saline. The rats in all groups were sacrificed after collecting peripheral blood specimen at 24 hours after model reproduction, and the levels of blood urea nitrogen (BUN) and serum creatinine (SCr) were determined. The pathomorphology change in renal tissue was observed under light microscope after periodic acid Schiff (PAS) staining. Real-time polymerase chain reaction (real-time PCR, RT-PCR) was used to determine the mRNA expressions of renal tubular autophagy related molecules Atg-5 and Beclin-1. Western Blot was used to detect the expressions of renal tubular autophagy associated protein microtubule labeled protein 1 light chain 3-Ⅱ (LC3-Ⅱ) and Beclin-1 as well as apoptosis protein cytochrome C (Cyt C), Bax and Bcl-2. TdT-mediated dUTP nick-end labeling (TUNEL) assay was used to determine the renal tubular epithelial cell apoptosis. Results Rapamycin could alleviate pathomorphology changes in rats with septic AKI, and decrease the levels of BUN and SCr. Compared with sham group, the expressions of Atg-5, Beclin-1 and LC3-Ⅱ in CLP model group were significantly increased [Atg-5 mRNA (2-ΔΔCt): 2.34±0.04 vs. 1.00±0.03, Beclin-1 mRNA (2-ΔΔCt): 1.40±0.02 vs. 1.00±0.03, LC3-Ⅱ protein (gray value): 0.82±0.03 vs. 0.45±0.04, Beclin-1 protein (gray value): 0.59±0.06 vs. 0.29±0.03, all P < 0.01]. Rapamycin could further up-regulate the expressions of Atg-5, Beclin-1, and LC3 Ⅱ [Atg-5 mRNA (2-ΔΔCt): 3.28±0.19 vs. 2.34±0.04, Beclin-1 mRNA (2-ΔΔCt): 2.38±0.08 vs. 1.40±0.02, LC3-Ⅱ protein (gray value): 1.11±0.07 vs. 0.82±0.03, Beclin-1 protein (gray value): 0.85±0.05 vs. 0.59±0.06, all P < 0.01]. Compared with sham group, the apoptotic cells in CLP model group were increased significantly [(34.49±10.45)% vs. (2.78±1.40)%, P < 0.01], Cyt C and Bax protein expressions were significantly up-regulated (gray value: 0.87±0.02 vs. 0.46±0.03, 1.20±0.06 vs. 0.46±0.01, both P < 0.01), and Bcl-2 expression was significantly down-regulated (gray value: 0.64±0.02 vs. 1.33±0.09, P < 0.01). Rapamycin could effectively inhibit cell apoptosis [(15.44±5.50)% vs. (34.49±10.45)%, P < 0.01] and the protein expressions of Cyt C and Bax (gray value: 0.72±0.03 vs. 0.87±0.02, 0.84±0.03 vs. 1.20±0.06, both P < 0.01), and up-regulate the protein expression of Bcl-2 (gray value: 0.77±0.04 vs. 0.64±0.02, P < 0.01). Conclusion The protective effect of rapamycin on renal tissue of rat with AKI induced by sepsis was depended on cell apoptosis inhibition through inducing and promoting cell autophagy.