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.

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

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.

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.

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.

OBJECTIVETo verify the clinical efficacy of acupuncture and moxibustion on depressive states of stroke patients' spouses.

METHODSForty-four subjects who were stroke patients' spouses and according with inclusive criteria with mild or moderate depressive states were randomly divided into an acupuncture-moxibustion group and a blank control group, 22 cases in each group. In the acupuncture-moxibustion group, acupuncture was applied at Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3), and suspended moxibustion was used at Shenque (CV 8), Guanyuan (CV 4) and Zhongwan (CV 12). The treatment was given twice a week for continuous 8 weeks. In the blank control group, neither acupuncture nor moxibustion treatment was given, and the patients were only treated with health and psychological guidance. Before treatment and after 8-week treatment, scores of self-rating depression scale (SDS) and numbers of insomnia severity grade were observed.

RESULTSIn the two groups, the scores of SDS were both reduced than those before treatment (both P<0.05), and the decrease in the acupuncture-moxibustion group was more obvious (P<0.05). After treatment, the number of insomnia severity grade in the acupuncture-moxibustion group was improved than that before treatment (P<0.001), and the improvement was evidently superior to that in the blank control group (P<0.05). The numbers of insomnia severity grade of the blank control group before and after treatment had no statistic significance (P>0.05).

CONCLUSIONThe acupuncture and moxibustion intervention plan has clinical treatment significance on the improvement of mild and moderate depressive states for the stroke patients' primary caregivers who are the patients' spouses.

Aged ; Depression ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Spouses ; psychology ; Stroke ; psychology

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.

Objective To explore the gene sequencing and prenatal diagnosis of Glanzmann thrombasthenia (GT). Methods The blood samples were drawn from one case of phenotype GT pediatric patient, patient’s parents, and one normal control. The amniotic lfuid and cord blood from the fetus of patient’s mother were collected. When the fetus was born 2 days, the blood was drawn. The coagulation routine test and platelet aggregation test were performed. The expression of platelet membrane glycoprotein (GP) IIb and GPIIIa were tested by lfow cytometry. Microsatellite technology is used to determine whether fetal cord blood is contaminated with maternal cells. The expressed region and the junctional zone between exon and introns of GPIIb and GPIIIa were ampliifed by PCR technology from blood sample of patient, patient’s parents, and fetus’s cord and 2 days after birth. The PCR products were then subjected to DNA sequencing. Results Adenosine diphosphate (ADP) cannot induce the platelet aggregation in the patient. The max rate of the platelet aggregation in the fetus’s cord blood was half of the normal. However, the max aggregation rate induced by ADP in the blood sample of parents and fetus 2 days after birth were equal to normal. The mean lfuorescence intensity (MnX) of platelet membrane GPIIb and GPIIIa in the patient were 10%and nearly zero of the normal control, respectively, while those in the parents, the fetus’s cord blood and 2 days after birth were more than 90%and 30%to 50%of the normal control. The cast-off cells in amniotic lfuid and the DNA in cord blood analysis by microsatellite technology conifrmed that the amniotic lfuid and cord blood not contaminated by maternal cells. Gene analysis showed the heterozygosis mutation in exon6 A3829→C and exon9 G42186→A of the patient’s GPIIIa led to the amino acid heterozygosis mutation in GPIIIaHis281→Tyr and Cys400→Pro. These two mutations came from the father and the mother separately. However, there was only one heterozygosis mutation in exon9 G42186→A in the cast-off cells in amniotic lfuid, the fetus’s cord and blood 2 days after birth. Conclusion This GT patient have double heterozygosis mutation. The fetus has heterozygosis mutation conifrmed after birth.