Objective To assess the risks of complications of loop colostomy and loop ileostomy.Methods The databases of Medline,Embase,Cochrane Library,Google Scholar and Wanfang were retrieved to identify the published studies comparing the advantages between loop colostomy and loop ileostomy.All the articles retrieved were published before April 15,2011.The incidence of complications was analyzed by Meta-analysis.The data were analyzed by the Z test and the heterogeneity of the data was analyzed by the Q test.Results Five randomized controlled trials and 8 non-randomized controlled trials with 1752 cases were included in the Meta-analysis.Compared with loop ileostomy,loop colostomy was associated with significantly increased risk of stoma prolapse ( OR =3.46,95％ CI:1.81-6.63,P ＜ 0.05 ).There were no significant differences in the incidences of stoma hemorrhage and stenosis,wound infection,stoma necrosis,parastoma dermatitis and hernia between patients who received loop ileostomy and those who received loop colostomy.Compared with loop ileostomy,loop colostomy was associated with increased risk of wound infection following stoma closure(OR =3.44,95％ CI:1.95-6.05,P ＜0.05).Compared with loop colostomy,loop ileostomy was associated with increased risk of postoperative bowel obstruction following stoma closure(OR =0.43,95 ％ CI:0.20-0.91,P ＜ 0.05 ).There was no significant difference in the risk of anastomotic leak between loop ileostomy and loop colostomy.Conclusion Compared with loop ileostomy,loop colostomy is associated with increased risk of stoma prolapse and wound infection after stoma closure,while a higher risk of bowel obstruction following stoma closure is observed after loop ileostomy.

Objective To introduce and investigate internal-fixtion with outboard proximal tibia anatomic plates through cut of anterolateral aspect of the leg.Methods 56 cases fracture of proximal tibia were fixed with outboard proximal tibia anatomic plates.Results All cases were followed up ranging from 5～18 months,with an average of 9 months.The excellent and good rate was 94.6% on Merchant grading system.Conclusions Internal-fixtion with outboard proximal tibia anatomic plates for the fracture of proximal tibia is an effective and reliable operation.

Objective To preliminarily investigate the clinical value of serum procalciton as a noninvasive marker in disease activity assessment in inflammatory bowel disease (IBD).Methods From January 2014 to June 2016,clinical data of 107 IBD patients were collected,including biological inflammatory parameters of peripheral blood such as serum procalcitonin levels,C-reactive protein (CRP) levels,erythrocyte sedimentation rate (ESR) and platelet count,clinical disease activity scores and endoscopic activity scores.The serum level of procalcitonin was measured using the traditional electrochemiluminescence immunoassay (ECL) method.The accuracy of diagnosis was analyzed by receiver operating characteristic (ROC) analysis.Kruskal-Wallis test and Spearman's rank correlation were performed for comparison between groups and correlation analysis.Results In the 60 patients with Crohn's disease (CD),the median serum level of procalcitonin of patients in active phase was higher than that of patients in remission phase (0.066 mg/L,0.047 mg/L to 0.168 rng/L vs 0.033 mg/L,0.024 mg/L to 0.044 mg/L),the median serum level of procalcitonin of patients in moderate to severe active phase was higher than that of patients in mild phase (0.112 mg/L,0.062 mg/L to 0.234 mg/L vs 0.046 mg/L,0.040 mg/L to 0.054 mg/L),and the differences were statistically significant (Z=4.883 and 3.326,both P＜0.01).There was a positive correlation between serum procalcitonin level and CRP,ESR,platelet count,plateletcrit,Crohn's disease activity index (CDAI) and Crohn's disease endoscopic index of severity (CDEIS) (r=0.494,0.387,0.339,0.328,0.736 and 0.689,all P＜0.05).The sensitivity and specificity of serum procalcitonin level ≥ 0.055 mg/L in predicting moderate to severe active CD were 85.0％ and 88.9％,respectively.The area under ROC curve (AUC) value of the combination of procalcitonin and CRP in diagnosing moderate to severe active CD was 0.905 (95 ％CI 0.827 to 0.982).In the 47 patients with ulcerative colitis (UC),the median serum procalcitonin level of patients in moderate to severe active phase was higher than those of patients in mild active phase and remission phase (0.059 mg/L,0.033 mg/L to 0.100 mg/L;0.030 mg/L,0.020 mg/L to 0.048 mg/L;0.030 mg/L,0.021 mg/L to 0.057 mg/L),and the differences were statistically significant (Z=2.056 and 2.783,P=0.040 and 0.005).Serum procalcitonin level was positively correlated with Mayo score,CRP level and Baron score (r=0.468,0.573 and 0.347,all P＜0.05).The specificity of serum procalcitonin level ≥0.065 mg/L in predicting moderate to severe active ulcerative colitis diagnosis was high but the sensitivity was low.Conclusion Serum procalcitonin may be of value in indicating the disease activity and severity.

Objective To observe the effects of hyperbaric oxygen (HBO) on learning and memory ability and on the level of myelin basic protein (MBP) in the brain tissue of rats with delayed neurological sequelae (DNS) after acute carbon monoxide poisoning (COP).Methods Forty-eight male SD rats had their cognitive performance assessed with the Morris water maze.After basic training with the Morris water maze and screening,the rats were randomly divided intoanormalcontrol (NC) group (n=11),a COP group (n=17) and an HBO group (n=17).Pure CO gas was injected intraperitoneally to establish acute COP in the latter two groups.The NC group received a similar injection of air.The HBO group was given HBO therapy.The rats in each group were tested for changes in their learning and memory abilities using the Morris water maze.On the 21 st day after the treatment,paraffin tissue sections of the rats' brains were subjected to immunohistochemical (IHC) examination and Western blotting (WB) was used to detect any expression of MBP in the brain tissue.Results After 21 days,morbidity among the COP group was 64.3％,while it was 26.7％ in the HBO group,a significant difference.The average maze escape latency in the COP group was significantly longer than in the HBO group.IHC staining and Western blotting showed that MBP in the hippocampal tissue of the COP group was significantly lower than that in the HBO group.In gray scale comparisons of the rats' brain tissue,that from the NC group was significantly better than that from the COP and HBO groups,but that from the HBO group was significantly better than that from the COP group.Conclusion HBO can effectively reduce DNS after acute COP,mitigate the severity of DNS,reduce demyelination of brain tissue and thus play an important role in protecting brain cells.

Objective To investigate the effects of lipoprotein lipase activator, NO-1886, on the mRNA and protein expression of glycogen synthase kinase-3β (GSK-3β) in the kidney of diet-induced diabetic minipigs. Methods Fifteen Guangxi Bama minipigs were randomized into three groups: C group (n=5, with the normal control diet), DM group (n=5, with the high-fat and high-sucrose diet), and NO-1886 group (n=5, with the high-fat and high-sucrose diet supplemented with 1.0% NO-1886). Plasma glucose, insulin, tfiglyceride (TG), oral glucose tolerant test, creatinine and blood urea nitrogen were measured monthly. Urinary samples in the morning were used for determination of microalbumin at month 0, 2, 4 and 5. The mRNA and protein expression of GSK-3β were measured by real time PCR, Western blot and immunohistochemistry in the kidneys obtained at the end of month 5. Results Compared with the C group, levels of plasma glucose, insulin, triglyceride and mieroalbuminuria were significantly increased in the DM group. The mRNA and protein expression of GSK-3β were increased in the kidneys of diabetic pigs (mRNA 0.0272±0.0052, protein 1.1600±0.0463, P<0.01) as compared with those of normal pigs (mRNA 0.0125±0.0045, protein 0.1385±0.0664). Compared with the DM group, the concentrations of plasma glucose, insulin, triglyceride and mieroalbuminuria obviously decreased in the NO-1886 group. The mRNA and protein expression of GSK-3β were decreased in the kidneys of the NO-1886 group (mRNA 0.0162±0.0019, protein 0.8429±0.0408, P<0.05) as compared with that of the DM group. Conclusion NO-1886 can improve disorders of glucose and TG metabolism and insulin resistance, and down-regulate the expression of GSK-3β in the kidneys, and protect renal function and morphologie damage in diet-induced diabetic minipigs.

Objective To compare the detecting results of rotavirus (RV)and adenovirus (AdV)antigens using auto stool pretreatment system (machine method)and manual method.Methods A total of 100 stools collectecd from diarrear patients admitted in gastroenterology outpatient department from September 2014 to Octorber 2014 in Peking University Medical College Hospital were detected to identify RV and AdV antigens using machine method and manual method respectively,and the nucletic acids of positive samples were detected by liquid chip method to verify the results.Results The RV,AdV and co-infection antigen positive detection rate using machine method were 17.0% (17/100),25.0% (25/100)and 12.0% (12/100)respectively,whereas those using the manual method were 4.0% (4/100),13.0% (13/100)and 2.0% (2/100),re-spectively.Taking the nucletic acids detection as the golden method,the false positive detection rate of RV,AdV and co-in-fection antigen using machine method were 23.5% (4/17),20.0% (5/25)and 33.3% (4/12)respectively,whereas those u-sing the manual method were 75.0% (3/4),69.2% (9/13)and 50.0% (1/2),respectively.χ2 test for paired data for RV and AdV positive detection rate,false positive detection rate of RV and false positive detection rate of AdV using two meth-ods were statistically significant (χ2 =15.0,52.8 and 47.5,P values <0.05).Two methods for detecting RV and AdV had poor consistency (Kappa value was 0.25,Kappa values <0.4).Conclusion Machine method has much more advantage on RV and AdV positive detection rate and false positive detection rate than manual method,which is good for clinical applica-tion.

Objective To explore the relationship between anxiety ,resilience and hope levels among gastric cancer patients ,so as to provide evi?dence for psychological intervention. Methods Cluster sampling design was used to select 324 gastric cancer patients. The anxiety self?assess?ment scale,resilience scale and hope scale are used to measure the related indicators. Results The comparative analysis showed that patients with different genders,education levels and marital status had different scores in anxiety level and resilience level(P<0.05),and those with differ?ent genders and marital status got different hope levels(P<0.05). Correlation analysis showed that anxiety was negatively correlated with resil?ience and hope levels(P<0.05),the coefficient of correlations ranged from-0.556 to-0.124. Multiple linear regression analysis showed that edu?cation level,marital status,income level,resilience,hope levels explained portion of the variance of anxiety. Conclusion Clinical nursing staff should reduce the gastric cancer patients′anxiety by improving their resilience and hope levels.

Objective To assess the value of central venous-to-arterial carbon dioxide difference [ P( cv-a) CO2 ] in evaluation of disease severity and prognosis in patients with septic shock.Methods There were 45 consecutive resuscitated septic shock patients from April 2009 to October 2010 included immediately after their admission into our ICU.The patients were divided into low P(cv-a) CO2 group and high P(cv-a) CO2 group according to a threshold of 6 mm Hg ( 1 mm Hg=0.133 kPa).All patients were treated by early goal directed therapy (EGDT).The parameters of hemodynamics,lactate clearance rate,the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ ) score,the sequential organ failure assessment (SOFA)score,6 h rate of EGDT achievement,the ICU mortality and 28 days in-hospital mortality were recorded for all patients.Results There were 30 patients in the low P(cv-a) CO2 group,and 15 in the high P(cv-a)CO2group.There were no significant differences between low P(cv-a) CO2 and high P(cv-a) CO2 patients in age,APACHE Ⅱ score and SOFA score (all P ＞ 0.05 ).Compared with the high P(cv-a)CO2 group,the low P(cv-a) CO2 group had higher cardiac index ( CI ) and 24 h CI,higher delivery O2 ( DO2 ) and 24 h DO2,higher central venous oxygen saturation ( ScvO2 ) [ (74 ± 9) ％ vs (67 ± 8) ％ ],lower lactate [ ( 3.4 ± 2.1 )mmol/L vs (5.7 ± 4.5 ) mmol/L] and higher △SOFA score [ (0.7 ± 1.8 ) vs ( - 0.4 ± 1.1 ) ],lower 24 h SOFA score [ (7.8 ± 2.0) vs (9.8 ± 2.0 ) ],higher 6 h rate of EGDT achievement ( 83.3％ vs 53.3 ％ )(P ＜ 0.05 ),however,there were no differences in 28 days mortality and ICU mortality between the two groups ( P ＞ 0.05 ).Conclusion P(cv-a) CO2 might be an indicator for predicting the severity of patients with septic shock and evaluating tissue perfusion.

Objective To express a recombinant protein TFPR1 ( the functional region of the snake venom proteins from Trimeresurus flavoviridis) in Pichia pastoris expression system. Methods The target gene was codon-optimized and synthesized according to the sequence of the conserved structural do-main of triflin and then cloned into the Pichia pastoris expression vector pPICZαA to construct the recombi-nant expression plasmid pPICZαA-TFPR1. The recombinant plasmid pPICZαA-TFPR1 was electroporated into the yeast strain X33. The transformed strains carrying expression plasmid were screened out with Zeocin and then induced by methanol to express the recombinant protein TFPR1. ELISA was performed for the screening of positive clones. SDS-PAGE and Western blot were used for further identification of the ex-pressed products. Results The recombinant plasmid pPICZαA-TFPR1 was successfully constructed. The recombinant protein TFPR1 was expressed in a secreted form at a molecular weight of 16×103. Conclusion The recombinant protein TFPR1 was successfully expressed in Pichia pastoris expression system, which laid a foundation for further researches on its biological function and application as an adjuvant.

OBJECTIVETo study the corneal penetration of PAMAM dendrimers-coated puerarin liposomes in rabbits.

METHODEvaluated PAMAM (G2, G3) dendrimers-coated puerarin liposomes were prepared and the in vitro transcorneal penetration were compared to puerarin drop solution and uncoated liposomes. The effect of different proportion of PAMAM to phospholipids in formulation on corneal penetration and the penetration parameters were investigated.

RESULTThe steady state fluxes and permeability coefficients of puerarin by PAMAM G2 (1.0%) and PAMAM G3 (0.5%) coated puerarin liposomes were greater than that by puerarin drop solution and uncoated liposomess (P < 0.01), meanwhile the PAMAM G2 (1.0%) and PAMAM G3 (0.5%) coated liposomes were better than other ratios of coated liposomes for improvement of corneal penetration (P < 0.01).

CONCLUSIONThe PAMAM coated liposomes is able to enhance the corneal penetration of puerarin and promising as an ocular drug carriers.

Animals ; Cornea ; metabolism ; Dendrimers ; chemistry ; metabolism ; In Vitro Techniques ; Isoflavones ; chemistry ; Liposomes ; chemistry ; metabolism ; Rabbits