Objective To study the therapeutic effect of e ndoscopic injection on Forrest graded peptic ulcer bleeding and evaluate its sig nificance.Methods From July 2001 to August 2002, eighty-one patients wi th haematemesis and/or hematochezia diagnosed as peptic ulcer by immediate endos copy were divided into two groups based on Forrest grading, 41 were treated with injection therapy (injection group); other 40 with conservative therapy only (c ontrol group).Results The haemostatic rates in injection therapy group and co ntrol group were 95 1% and 80 0% respectively with prominent statistical diffe rence (P

0.05),but significant difference in procalcitonin((2.12?1.57) vs(1.60?0.58)ng/ml,P

Objective To explore the etiological diagnosis of obscure gastrointestinal bleeding in patients undergoing double-balloon enteroscopy and summarize the nursing strategies.Methods Eighty-six patients with obscure gastrointestinal bleeding underwent double-balloon enteroscopy. Before operation,preparations of surgical stuff and bowel were conducted,during the operation,surgical cooperation was carefully performed and after the surgery and the patients were closely observed for prevention of complications.Results All the patients lived through the enteroscopy without any complications of perforation and bleeding. The positive detection rate was 83.7%.Conclusion Double-balloon enteroscopy is of great accuracy etiologically for the diagnosis of obscure gastrointestinal bleeding. The nursing measures including right evaluation of patients' condition,careful pre-operational, proficient surgical cooperation and close observation are of great significance for the success of double-balloon enteroscopy.

Life education aims at avoiding the consequent self-suicides of college students.Rich resources can be provided from traditional culture.Possible ways of life education from the perspective of traditional culture include educate through the curriculum teaching of Chinese Language and Culture,through the studying of the ancient Chinese classicals and through properly increasing the ratio of the training of traditional Chinese Wushu in current PE classes for college students.

Objectives To understand the mutations of embB genes in M. tuberculosis isolates, and to evaluate their clinical value. Method 102 clinical isolates were identified for their mycobacterial species, and then analyzed their embB genes with PCR SSCP, PCR RFLP, and PCR direct sequencing. Results Mycobacterium tuberculosis strain H 37 R v was used as a control. 102 clinical isolates all had the same 16S rDNA SSCP profiles as M. tuberculosis . Forty one drug sensitive isolates had normal embB SSCP and RFLP profiles. Of 61 ethambutol resistant isolates, 23 (37.7%) displayed abnormal embB SSCP profiles. Eight isolates had abnormal RFLP profiles. All embB mutations situated at codon 306, whose EMB MICs were more than 20 ?g/ml. Eight isolates had ATG to ATA or ATT mutations at codon 306. Thirty isolates had ATG to GTG or CTG mutations at codon 306, whose EMB MICs were more than 30 ?g/ml. Conclusions Ethabutol resistances in some M. tuberculosis isolates were due to mutations on embB genes. PCR SSCP and PCR RFLP method might become a simple and rapid diagnostic test for genotypes of M. tuberculosis ethabutol resistance.

Objective To investigate the effects of IFN-? and IL-4 on MIP- ? production of peripheral blood mononuclear cells (PBMC) in lupus nephritis (LN) Methods MIP-1? expression in supematants was determined by Elisa and MLP-l? mRNA in PBMC was detected by RT-PCR. Results (1) IFN-? increased MIP-1? prouduction of PBMC in LN. (2) IL-4 inhibited MIP-1? production of PBMC in LN. (3) No significant effect on PBMC in controls was found by either IFN-? or IL-4. Conclusion IFN-? enhances MLP- 1? production of PBMC in LN wherease LL-4 inhibits it.

Objective:To explore the molecular mechanism of Guchang-Zhixie pill in the treatment of ulcerative colitis based on network pharmacology. Methods:Retrieve the TCMSP database to get the effective components and target genes of each drug in Guchang-Zhixie pill, and then retrieve the OMIM database Disgenet database to get disease genes, and then intersect the drug genes and disease genes to get the core genes. Used STRING database to build gene function association network, and used DAVID database to analize go enrichment and pathway enrichment of the core genes. Results:A total of 77 active ingredients and 211 targets of Guchang-Zhixie pill were obtained by TCMSP database, 914 genes of ulcerative colitis were obtained by retrieving disease gene database, 72 core genes were obtained by intersection of drug gene and disease gene. Topology analysis showed that the core targets were IL6, IL1B, MAPK1, VEGFA, MMP9, etc; Twelve enriched biological process clusters were obtained. The biological processes with more contact targets were positive regulation of RNA polymerase Ⅱ promoter transcription and positive regulation of DNA template transcription; A total of 14 enriched pathway clusters were obtained by pathway enrichment analysis, among which TNF signaling pathway and PI3K/Akt signaling pathway were closely related to inflammation and associated with more targets. Conclusion:The target and pathway of Guchang-Zhixie pill in the treatment of ulcerative colitis are preliminarily obtained through database analysis, which has provided the reference for clarifying its mechanism.

Objective:To study the optimal pain control goal for preventing delirium in critical patients.Methods:A prospective cohort study were conducted. The patients admitted to general departments and transferred to the intensive care unit (ICU) due to critical illness in the First People's Hospital of Changde from January 2017 to November 2019 were enrolled. The General data of the patients were collected within 48 hours after admission. All patients admitted to the ICU were evaluated for pain level using the critical care pain observation tool (CPOT) every 8 hours by nurses, and confusion assessment method of ICU (CAM-ICU) was used to screen delirium patient every 8 hours by the leader of nursing team without knowing the pain level of the patients, until the subjects were transferred out of ICU. The receiver operating characteristic (ROC) curve was drawn, the area under ROC curve (AUC) and the optimal threshold were analyzed with delirium as the reference standard; according to the optimal threshold, multivariate Logistic regression analysis was used to evaluate the correlation between CPOT score and delirium.Results:During the study period, 575 patients were admitted to the participating departments and passed the preliminary screening according to the inclusion and exclusion criteria. During the study period, 34 patients were excluded due to incomplete data. Finally, a total of 541 patients were enrolled in the analysis, including 149 patients in delirium group and 392 patients in non-delirium group. There was no significant difference in gender, age, source of patients, education level, smoking history, drinking history, family mental history, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or other general information between the two groups. There were 10.1% (15/149) of patients in the delirium group used opioids, which was significantly higher than 4.3% (17/392) in the non-delirium group, and the difference was statistically significant ( P < 0.05). The CPOT score in the delirium group was significantly higher than that in the non-delirium group (4.24±1.78 vs. 2.75±1.95, P < 0.01). The patients were subdivided into young group (< 40 years old), middle-aged group (40-65 years old) and old group (> 65 years old) according to age. The analysis results were consistent with the overall analysis results. ROC curve analysis showed that the AUC of CPOT score predicting delirium was 0.719; when the best threshold value of CPOT score was 2.5, the sensitivity was 91.3%, the specificity was 49.0%, the positive predictive value was 40.5% and the negative predictive value was 93.7%. Multivariate Logistic regression analysis showed that the risk of delirium in ICU patients with CPOT score ≥ 3 was 10.043 times higher than that in patients with CPOT score < 3 [odds ratio ( OR) = 10.043, 95% confidence interval (95% CI) was 5.498-18.345, P < 0.001]. When the gender, age, APACHEⅡ score, smoking history, drinking history, opioids usage were adjusted, the risk of delirium in patients with CPOT score ≥ 3 was 10.719 times higher than that in patients with CPOT score < 3 ( OR = 10.719, 95% CI was 5.689-20.196, P < 0.001). Conclusion:The best pain control goal for preventing the occurrence of delirium in ICU patients is a CPOT score of 3 or less.

Objective To detect the opening of the myocardial mitochondrial permeability transition pores (MPTP) after intrauterine asphyxia in neonatal rats,and to explore the mechanism of the myocardial hypoxic-ischemic and reperfusion injury caused by the opening of MPTP after asphyxia.Methods Cesarean sections were undertaken in female SD rats at the 21st day after pregnancy.The uterine arteries were clamped for 30 minutes followed by releasing for 1 hour and the pups were allocated into the asphyxia group.The uterine arteries were isolated but not clamped and the pups were allocated into the control group.There were 30 neonatal rats in either group and all of them were sacrificed 24 h after birth.Serum cardiac troponin Ⅰ (cTn Ⅰ) levels were detected by enzyme linked immunosorbent assay.The opening degree of MPTP was detected by fluorospectro-photometry.Myocardial ischemic areas were detected by TTC staining.Tissues from the cardiac apex were taken and the pathologic changes of the myocardium were explored by hematoxylin-eosin staining.SPSS for Windows 13.0 was used for statistic analyses.Results In HE staining slices,the myocardial cells in asphyxia group were disarranged and edematous.In control and asphyxia group,the serum cTn Ⅰ levels were (0.08 ±0.04) μg/L and (0.40 ±0.29) μg/L (P ＜0.01),the myocardial ischemic areas were (8.01 ±3.48) ％ and (42.50 ± 15.90)％ (P ＜0.01),and the opening degrees of MPTP were (118.10 ± 19.10) RFU and (79.40 ± 10.57) RFU (P ＜ 0.01) respectively.The serum levels of cTn Ⅰ,the myocardial ischemic areas,and the opening degrees of MPTP were significantly increased in asphyxia group compared with control group.The serum level of cTn Ⅰ was positive correlated with the opening degree of MPTP in either group(r =-0.384,P ＜ 0.01).Conclusion There are myocardial injuries in neonatal rats after asphyxia,which represent as high level of serum cTn Ⅰ,myocardial ischemia and necrosis.Opening of the myocardial MPTP is one of the causes of myocardial injury.

Objective To investigate the optimized parameters of dye (SYBR Green Ⅰ) realtime fluorescent polymerase chain reaction (RF-PCR) for detecting αβT lymphocyte clones in the peripheral blood and its application in monitoring specific T cell clone in the peripheral blood mononuclear cells (PBMC) from patients with chronic hepatitis B (CHB). Methods The total RNA was extracted from the PBMC of six healthy donors, and was reversely transcripted into cDNA. Then the cDNA was amplified using RF-PCR with the primers specific for T cell receptor β viable region (TCRBV) gene families as upstream primers and the primer for T cell receptor (TCR) β constant region (TCRBC) as downstream primer. The annealing temperature,concentration of primers and the total number of cycles were comparatively analyzed. The optimized PCR was performed to investigate the 24 TCRBV gene families from 12 patients with CHB, and the PCR products were monitored by melting curve analysis, and the clone expansion of peripheral blood T cell was detected by peak-motif of melting curve analysis. Results The optimized annealing temperature, final premier concentration,the number of cycles were 60.6 ℃, 0.5 μmol/L and 40 cycles, respectively. The begin temperature for melting curve analysis was better as 80 ℃ compared to 75 ℃. There was mono-peak on melting peak chart for TCRBV gene families in PBMC from patients with CHB, and PCR products of the single peak were determined as monoclonal T cell by sequencing. Conclusions The optimized reaction parameters of RF-PCR for monitoring 24 TCRBV gene families are determined. The melting peak chart could be used to monitor the clone expansion of the peripheral lymphocytes and to detect the clone-specific T cells in the peripheral blood from patients with CHB.