Objective To observe the changes of PI3K/Akt signaling pathway and endoplasmic reticulum stress related protein GRP78 and CHOP in CCl4 induced liver fibrosis and to explore their effects on hepatic fibrosis.Methods Thirty SD rats were randomly divided into normal control group, 4 and 8 weeks liver fibrosis group (hypodermic injection of 40% CCl4).Pathological changes of liver tissue was observed by HE staining.The techniques of real-time PCR was applied to detect mRNA of GRP78 and CHOP in liver.Detected expression of Akt1, phospho-Akt1, GRP78 and CHOP protein by western blot.Meanwhile, the cell apoptosis in liver was detected by TUNEL.Results Compared with the normal control group, GRP78 and CHOP mRNA and protein in 4 and 8 weeks liver fibrosis group was increased(P<0.05), while expression of Akt1, phospho-Akt1 in 4 and 8 weeks liver fibrosis group was lower than that in normal control group(P<0.05).Compared with normal control group, the apoptosis of hepatocytes in 4 and 8 weeks liver fibrosis group was elevated (P<0.05).Conclusions PI3K/Akt signaling pathway and endoplasmic reticulum stress may play important roles in the induction of apoptosis of hepatocytes in rats with hepatic fibrosis.

Objective To explore the feasibility of laparoscopic splenectomy (LS) in the management of ruptured spleen. Methods Laparoscopic splenectomy was performed in 8 cases of ruptured spleen in this hospital from August 2004 to May 2005. Results Laparoscopic splenectomy was accomplished successfully in 7 cases and a conversion to hand-assisted laparoscopic splenectomy (HALS) was needed in 1 case. The operation time was 150~200 min (mean, 180 min). The intraoperative blood loss was 600~5 500 ml (mean, 2 200 ml). There were 5 cases of type Ⅱ rupture and 3 cases of type Ⅲ rupture. The postoperative recovery was uneventful and no complications were encountered. Conclusions[WTBZ] Laparoscopic splenectomy is a safe and feasible option for the management of ruptured spleen.

Objective To analyze the relocation stress and its influencing factors of the families of patients transferred from ICU.Methods Totally 101 ICU patients' families were recruited by convenience sampling approach from three hospitals between October and December,2016.General information questionnaire and the relocation stress scale for the families of patients transferred from ICU were used to collect data.Results The relocation stress score was 55.49±6.30.The average score of the total items was 3.25±0.55.Multiple regression analysis showed that education level of family members,family members' gender,age of patients and the time of patients staying in ICU were main factors affecting the relocation stress of the families of patients transferred from ICU(P＜0.05).Conclusion The families of patients transferred from ICU have a certain intensity of relocation stress.Family members with low education level,being female,younger age of patients and long duration of staying in ICU have relatively high relocation stress.

ICU treatment experience is the major source of patients′psychological stress as well as their relatives. Because of physical strain, sedation, invasive therapies, patients with critically ill usually tend to have some delusion, nightmare and memory loss, which cause several psychological disorder such as anxiety, fear and depression. The intensive care diary plays an important role in fill in memory gap , distinguish between delusion and reality ,make sense of illness experience, it is helpful to protect patients and their relatives from psychological disorders. Ever-growing scholars apply the intensive care diary to patients′post-ICU psychological rehabilitation. This review aim to introduce the concept, content, benefit as well as application status, provide some reference of the use in our country.

0.05).The expression of bcl-2 in sham group was significantly higher than that in GC and ADX groups(P0.05)was observed.The ratio of bax to bcl-2 in sham group was significantly lower than that in GC and ADX groups(P

In recent years, the number of ICU survivor is ever-growing with the increase of cure rate. The survivors′ outcome has aroused more and more attentions from medical personnel. ICU survivors tend to experience lasting physical, psychological and cognitive injuries, the post-traumatic stress disorder is one kind of significant psychological injury associated with patients′ critical experience. This review aims to summarize relevant literatures, introduces the prevalence, risk factors, complications, and interventions of ICU survivors′ post-traumatic stress disorder symptom, in order to prevent ICU survivors from post-ICU psychological injury and improve their long-term outcome.

MicroRNAs (miRNAs) , a species of small noncoding RNA, could regulate gene expression bv binding to the 3'-untranslated region of target mR NA at post-transcription level.MicroRNAs play important roles in various human biological processes such as differentiation, cell proliferation, and apoptoMs.Abnormal expression of miRNAs is implicated in carcinogenesis and progression of various cancers, indicating that miRNAs could be served as molecular biomarkers for diagnosis and treatment of cancer.In this resiew, the author summarize the most common altered miRNAs expression profiles and their possible roles in promoting cell proliferation, tumor metastasis,and chemotherapeutic resistance in gastric cancer.

Objective To establish a cosmetic medicine bio-psycho-social model and its theory frame and a new clinical work system. Methods The clinical observation and clustering analysis were used in this study, which based on the modern medicine patterns to carry on the logical proof, theory derivation and systematic design. Results The bio-psycho-social model of cosmetic me dicine with combination of the theory and practice was established, including its concept, theory constitution and clinical work system. Conclusion The bio-psycho-social model of cosmetic medicine can most scientifically and comprehensively explain this discipline rule and clinical work, and it will bring the profound influence on the development of the theory and practice in cosmetic medicine.

Objective To compare the effects of gastric residual volume (GRV) set at different thresholds on intensive care patients receiving enteral nutrition (EN),so as to inform clinical practice.Methods Controlled clinical trials involving different GRV thresholds in ICU patients undergoing EN were retrieved from multiple electronic databases (including Cochrane Library,PubMed,Ovid Medline,Web of Science,CBM,CNKI,Wanfang Data,and VIP).Quality of the retrieved studies was evaluated for data extraction,and meta-analysis was performed.Results Four randomized controlled trials and one clinically controlled trial were included in the study,with a total of 658 subjects.Results of the meta-analysis suggested no statistically significant difference between the group with GRV threshold≥250 ml and the one with GRV threshold＜250 ml in the rates of pneumonia (OR =1.19,95％ CI =0.77-1.82,P =0.43),aspiration.(OR =1.59,95％ CI =0.42-6.03,P=0.50),vomiting (OR=1.35,95％ CI=0.48-3.80,P=0.57),reflux (OR=1.29,95％ CI=0.58-2.88,P=0.53),and diarrhea (OR=1.36,95％ CI=0.87-2.13,P=0.17).Nutrient intake and several other outcome measures were unable to be included in the meta-analysis for either the scarcity of studies or inconsistency in the measures adopted,and descriptive analysis was therefore employed instead.Conclusion There was no significant difference between the two groups in terms of complications,but the group with GRV threshold≥250 ml had higher intake of EN.

Objective To investigate the current status of emotional labor of ICU nurses and its influence on job burnout.Methods Totally 253 ICU nurses of three comprehensive third-grade class-A hospitals were investigated using the general information questionnaire and nurses' emotional labor scale and job burnout scale.Results The average score of emotional labor was 3.59±0.67.The scores of deep acting,expression of genuine emotion and surface acting were 4.67±0.86,3.37±0.91 and 3.26±0.86.There was a relationship between the factors of emotional labor and job burnout.The surface acting had positive prediction effect on emotional exhaustion(β=0.317,P＜0.01) and depersonalization(β=0.292,P＜0.01),and negative effect on personal achievement (β=-0.144,P＜0.05).Deep acting had negative predictive effect on depersonalization(β=-0.283,P＜0.01) and positive prediction effect on personal accomplishment (β=0.345,P＜0.01).Conclusion ICU nurses have moderate levels of emotional labor,and the deep acting score is the highest between three dimensions.The surface acting and deep acting can predict job burnout,and managers of hospital should pay attention to the education and training of emotional labor for ICU nurses.