Objective To study the effect of compound nutritional therapy on end-stage liver disease patients with pressure ulcers at Ⅱ phase got from outside the hospital. Methods A total of 101 end-stage liver disease patients with Ⅱ phase pressure ulcers were divided into the observation group (50 cases) and the control group (51 cases) by random digits table method. The control group was treated by conventional diet and drug, and the treatment group was treated by compound nutritional therapy except the conventional diet and drug. The pressure ulcers were assessed daily and the patients were reviewed weekly during treatment. The outcomes of the difference of wound healing and nutritional status improving were compared between the two groups. Results After 14 d treatment, the total of wound healing cure rate was 42.6% (29/68), the total effective rate was 94.1% (64/68) in the observation group, the total of wound healing cure rate was 27.6%(18/65), the total effective rate was 73.8%(48/65) in the control group, and there was significant difference between two groups (χ2=12.726, P=0.005). The healing time was (12.87±2.46) d in the observation group, significantly shorter than that in the control group (17.26±3.51) d, there was significant difference (t=2.760, P=0.005). Conclusions For the end-stage liver disease patients with pressure ulcers at Ⅱ phase got from outside the hospital, compound nutrition therapy can improve the nutritional status, promote the pressure ulcers healing, reduce the economic burden and improve the overall curative effect.

Henoch-Schonlein purpura (HSP) is the most common vasculitis disease in childhood.It is a multisys-tern disease that most commonly affects skin,joints,gastrointestine and kidneys.The causes and pathogenetic mechanisms underlying HSP have not been understood yet.Recently great progress have been made on HSP and attention has been paid to the relationship between P-selectin and HSP.This article summarizes recent work in the advancement of P-selectin and HSP.

A simple,fast and highly sensitive fluorescence analysis method for detection of mercury ion was developed based on N-methyl-mesoporphyrin IX (NMM)/G-quadruplex DNA system and specific T-Hg-T mismatches.In this strategy,a large number of thymine was introduced into guanine-rich oigonucleotides which could form G-quadruplex.In the presence of Hg2+,guanine-rich oigonucleotides and complementary strand could form double-stranded DNA molecule by specific T-Hg-T mismatch pair,leading to destruction of G-quadruplex DNA structure.In the absence of Hg2+,guanine-rich oigonucleotides spontaneously formed G-quadruplex DNA structure that could bound NMM to generate intense fluorescence.Based on the above facts,a sensitive fluorescence biosensor for determination of Hg2+ was fabricated.And the optimal conditions for Hg2+ determination were as follows:buffer solution pH of 6.7,20 mmol/L KCl and 2.5 μmol/L NMM in buffer and incubation for 2 h.Under the optimal conditions,the fluorescence intensity signal change (F0-F) and the Hg2+ concentration exhibited a linear correlation within 50 nmol/L to 1000 nmol/L range with a low detection limit of 22.8 nmol/L (3σ).The biosensor exhibited good selectivity toward common metal ions.The developed method was successfully employed to detect Hg2+ in tap water with recovery of 106.1％-107.8％.

score, prostate volume and peak urinary flow rate, correlate with BPH, but not with nocturia. Keeping a detailed urinary diary for the patients is beneficial for elucidating their urinary function and in decision-making of their treatment regimen.

Objective:To conduct a survey on the difference in medical staff remuneration level and satisfaction within the eastern, central and western township health centers, explore the influencing factors on remuneration satis-faction, and put forward some suggestions. Methods:909 medical staff and 104 township health centers from 9 coun-ties in the eastern, central and western regions were investigated. The Descriptive, ANOVA and Hierarchical Linear Model ( HLM) methods were used to analyze the survey results. Results:Average annual medical staff remuneration was 28 324 Yuan in 2011 and the remuneration satisfaction was 2. 77 in five-point scale. The difference between the remuneration level (F=140. 16,P<0. 001) and remuneration satisfaction (F=240. 84,P<0. 001) among three re-gions was statistically significant. The HLM analysis indicated that the working time, workload per day in individual level and whether by practicing the policy of separation between revenue and expenditure, the number of average monthly discharged patients and the fiscal appropriation income in the township health centers level affected the remu-neration satisfaction. Conclusions:The medical staff remuneration level and satisfaction in the township health centers were low, both having a great regional difference. Therefore, the improvement of the medical personnel remuneration satisfaction is obtained through improving the revenue and expenditure, and the performance-based pay system.

Objective To assess the effect of continuous renal-replacement therapy (CRRT) dose on the outcome of acute renal failure (ARF) patients with meta-analysis of randomized controlled trials (RCTs). Methods Studies were identified by systematic search of peer-reviewed publications in Medline, EMBASE and Cochrane library database through June 2010. All the RCTs that compared the incidence of clinical outcome such as mortality, need for chronic dialysis between standard and low dose CRRT were eligible. The pooled relative risk (RR) for clinical outcome was compiled using a random-effects model. Heterogeneity was evaluated by means of subgroup and sensitivity analysis. Results Six eligible studies were identified. By meta-analysis, standard dose CRRT was associated with non-significant 13% mortality risk reduction (RR 0.87, 95%CI 0.70-1.07, P=0.19)and 13% composite outcome risk reduction of chronic dialysis dependence and mortality (RR 0.87, 95%CI 0.69-1.09, P=0.21), but the trend toward increased chronic dialysis dependence risk among survivors (RR 1.43, 95%CI 0.94-2.18, P=0.09). The overall test for heterogeneity among cohort studies was significant (P=0.001, I2=76.2%). The risk of mortality was modality was significantly lower in some studies of which delivered dose was moer than 35 ml·kg-1·min-1,modality was continuous venous-venous hemofiltration (CVVH) and major cause was non-sepsis treated with standard dose CRRT. Conclusions Standard dose CRRT in patients with ARF does not improve survival, renal recovery and composite outcome, but decreases mortality in important subgroups including those with higher delivered dose, CVVH and non-sepsis.

Objective To compare using the transabdominal route versus the transoral route in establishing naso-biliary drainage in laparoscopic surgery.Methods The combined use of laparoscopy with choledochoscopy and duodenoscopy to establish naso-biliary drainage was carried out in 204 patients with gallbladder and common bile duct calculi.In 162 patients,the naso-biliary drainage was established transabdominally and in 42 patients it was established transorally.The success and the complication rates in the two groups were compared.Results Of 162 patients using the transabdominal route,4 patients failed.There were 6 patients (3.7％) who had no output from the nasobiliary drain.There were 3 patients (1.8％) who had only intestinal juice outflow from the nasobiliary drain.Primary closure failed in 3 patients (1.8％),all resulting in bile leak.Pancreatitis occurred in 2 patients (1.2％) after the operation.There was 1 patient (0.6％) whose nasobiliary drain was wrongly ligated.Of 42 patients with nasobiliary drainage using the transoral route,6 patients failed.There was 1 patient (2.4％) who had no output from the nasobiliary drain.There was 1 patient (2.4％) who had intestinal juice output from the nasobiliary drain.Primary closure failed in 1 patient (2.4％) with resultant bile leakage.Pancreatitis occurred in 4 patients (9.5％) after the operation.The success rate of establishing a nasobiliary drainage in the transabdominal group was significantly higher than that in the transoral group,but the complications were less.Conclusions Nasobiliary drainage established through the transabdominal route in laparoscopy surgery for patients with gallbladder and common bile duct calculi was technically easier and had a high success rate.It had less complications.

Objective To observe the effects of limited fluid resuscitation (LFR) on immune function and inflammatory mediators in patients with multiple bone fracturescomplicated with traumatic hemorrhagic shock. Methods One hundred and two patients with multiple bone fractures complicated with traumatic hemorrhagic shock admitted to the Affiliated Hospital of Medical College of Ningbo University from January 2014 to June 2016 were enrolled, and they were divided into a LFR group and a early sufficient routine fluid resuscitation (RFR) group by random number table, each group 51 cases. After admission, the patients in the two groups underwent bandaging and hemostasis at the traumatic sites and preoperative management was prepared. The patients in RFR group were treated with early sufficient RFR, while LFR group was treated with LFR. The changes of hematocrit (HCT), blood platelet count (PLT), prothrombin time (PT), blood lactic acid and immune cells, inflammatory mediators and micro RNA-155 (miR-155) were observed in patients of the two groups at 4 hours after resuscitation.Results Compared with RFR group, the resuscitation time (hours: 3.67±1.45 vs. 5.14±1.61), levels of PT (s: 11.43±2.21 vs. 15.73±2.52), serum lactic acid (mmol/L: 3.35±0.15 vs. 3.81±0.25), tumour necrosis factor-α [TNF-α (ng/L): 14.10±3.39 vs. 16.28±3.47], interleukin [IL-10 (ng/L): 31.43±10.51 vs. 40.09±13.23, IL-6 (ng/L): 490.10±55.13 vs. 610.30±63.15] and endothelin-1 [ET-1 (pg/L): 183.35±30.51 vs. 250.01±31.23] in LFR group were significantly decreased (allP < 0.01), while PLT (×109/L: 134.58±28.13 vs. 108.12±30.35), HCT (×10-2: 0.34±0.04 vs. 0.24±0.05), miR-155 (0.15±0.02 vs. 0.08±0.02) and CD4+CD25+ regulatory T cell [CD4+CD25+Treg (×10-2): 2.28±0.47 vs. 2.10±0.39] in LFR group were obviously increased (allP < 0.01).Conclusions Using LFR in the emergency treatment of patients with multiple bone fractures complicated with traumatic hemorrhagic shock can effectively shorten the resuscitation time, regulate the patients' coagulation function, reduce the unnecessary excessive liquid infusion, improve immune status and decrease the degree of inflammatory reaction.

Objective To investigate the clinical significance of CD28 expression on peripheral blood T lymphocytes in children with juvenile idiopathic arthritis (JIA).Methods Flow cytometry and tri-color direct immunofluorescence were used to examine CD3 + T lymphocyte subsets and CD28 expression in whole blood (using the no-wash method) from 36 children with JIA.Results During the active phase of disease,the frequency of CD28 + expression on both CD4 + and CD8 + T cells in the peripheral blood of children with JIA was significantly lower than in normal controls (P ＜ 0.01).The frequency of CD4 + CD28-T cells in the peripheral blood of children with JIA was significantly higher than in normal controls (P ＜ 0.01).CD4 + T cell counts in the peripheral blood of children with JIA,which were mostly of the CD4 + CD28-T cell subtype,were significantly higher than in normal controls (P ＜ 0.01),whereas the CD8 + T cell count was significantly reduced (P ＜0.01).During the resting phase,CD4 +/CD8 + T cell counts and CD28 expression in the peripheral blood of children with JIA were significantly different from normal controls (P ＞ 0.05).Conclusions The frequency of CD4 + CD28-T cells can be used as an indicator of the active phase of JIA.CD4 + T cell and CD4+ CD28-T cell apoptosis was inhibited in JIA patients.These immune-active T lymphocytes with continued survival can promote the occurrence and development of JIA.

BACKGROUND:In the cytotoxicity test of the mussel adhesive protein dressing for wound healing, because of positive charge properties of the protein, when extracting ratio is 1:9, the cel s exhibit poly-group phenomenon that results in errors in the cytotoxicity test of mussel adhesive protein samples.
OBJECTIVE:According to the existing standards, to improve the leaching proportion and pretreatment of mussel adhesive protein dressing for wound healing based on the special properties and working condition of mussel adhesive protein.
METHODS:(1) Extract method:Extract solution of mussel adhesive protein dressing was prepared with mussel adhesive protein dressing and cel medium at extracting ratios of 1:9 and 1:131. Then, L929 cel s were cultured in extract solutions of mussel adhesive protein dressing, natural latex and high-density polyethylene, respectively. (2) Method of direct contact:Distil ed water, solutions of mussel adhesive protein dressing, dimethyl sulfoxide and cel medium were used to culture L929 cel s.
RESULTS AND CONCLUSION:When the extracting ratio was 1:9, the cel s agglomerated which is not suitable for cytotoxicity test. When the extracting ratio was 1:131, flocculated sediment and cel aggregation disappeared, the cytotoxicity test results showed no cytotoxicity with higher reliability. Direct contact method showed the samples had no cytotoxicity. The extract method with adjusted extracting radio or direct contact method can be applied to test the in vitro cytotoxicity of mussel adhesive protein dressing for wound healing.