Child ; Contraindications ; Humans ; Kidney Diseases ; immunology ; Risk Factors ; Vaccination

OBJECTIVE: To discuss advances in intrahepatic and intrabiliary stent application and evaluate their biocompatibility.METHODS: A computer-based online search of CNKI between 1989 and 2009 was performed to search related articles with the keywords of "bile duct, hepatic duct, stent, treatment". A total of 51 articles were searched and 20 were included according to inclusion and exclusion criteria. The articles were summarized from aspects of treatment advances in intrahepatic and intrabiliary stent application and prevention of obstruction following intrahepatic and intrabiliary stenting; the clinical application of intrahepatic and intrabiliary stent, biocompatibility and prevention of stent obstruction were discussed.RESULTS: Intrabiliary stent mainly includes metal stent and plastic stent. The metal stent is superior over plastic stent in preventing bacteria and keeping stent patency, but its cost is large. The plastic stent is easy for bacteria attachment and stent obstruction, but it is simple to change the stent and the cost is low. Intrabiliary stent implantation is the best method to treat malignant obstruction of bile duct with few complications. Intrahepatic stent in combination with various radiotherapies can prolong effective patent time of the stent and effectively prevent stent obstruction. CONCLUSION: Intrabiliary stent implantation is the most effective clinical method to treat malignant obstruction of bile duct.However, the biocompatibility of various intrabiliary stents should be improved. Intrahepatic stent in combination with radiotherapies can prevent stent obstruction.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Oculomotor Nerve Diseases ; therapy ; Young Adult

ATP Binding Cassette Transporter, Sub-Family B ; metabolism ; Animals ; Anticonvulsants ; pharmacology ; Brain ; drug effects ; metabolism ; Rats

Objective To evaluate the effects of aerobic combined strength and balance exercise on cognitive function and satisfaction in patients with cognitive impairment no dementia. Methods Four hundred and twenty patients with cognitive impairment no dementia were divided into control group (200 cases) and experimental group (220 cases) by random digits table method. The control group received general health education and rehabilitation training. The experimental group received aerobic combined strength and balance exercise. The patients were assessed with Montreal Cognitive Assessment (MoCA) to evaluate their cognition before training, as well as after training. And the patients′satisfaction with the questionnaire was evaluated. Results The total scores of MoCA, scores of name, attention, language, memory and directionafter training were (23.47 ±2.38), (2.77 ±0.42), (5.09 ±0.86), (2.50 ±0.65), (3.42 ±0.68), (5.03 ± 0.10) points in the experimental group, and (21.20±2.55), (2.31±0.76), (4.71±1.10), (2.35±0.70), (2.23±0.81), (4.48±0.96) points in the control group, and there were significant differences, P<0.05. There were no significant differences in the space and abstract thinking between experimental group and control group:(3.61±0.91) points vs. (3.45±1.09) points, (1.83±0.76 ) points vs. (1.72±0.52) points, P>0.05. The scores of satisfaction in the experimental group was significantly higher than that in the control group:(49.33 ±1.57) points vs. ( 48.20 ±2.14) points, P<0.01. Conclusion The application of aerobic combined strength and balance exercise could improve the cognitive function and patients′satisfaction.

ObjectiveTo investigate the influence of the midazolam sedation based on remifentanil analgesia on the occurrence of delirium in critically ill patients in intensive care unit (ICU).Methods A single-center prospective randomized controlled trial was conducted. 140 consecutive critically ill patients admitted to ICU of Peking University People's Hospital, undergoing mechanical ventilation longer than 24 hours, with the need of sedation, from February 2014 to January 2015 were enrolled. They were randomly divided into two groups by computer generated random numbers table, eachn = 70. The patients in observation group received midazolam 1μg·kg-1·min-1 for sedation, and 1 mg/mL remifentanil for analgesia with 0.05 mg/kg intravenous bolus, then continuous infusion of 0.02-0.10 mg·kg-1·h-1. The patients in control group received midazolam for sedation only. The data were recorded as follows: the main indices for observation included the occurrence of delirium and its duration; the second item for observation was consumption of drug for sedation, followed by the mean arterial pressure (MAP) before and after sedation, the time of wake-up, duration of mechanical ventilation, the length of ICU stay, and 28-day fatality rate. The 28-day survival was analyzed by Kaplan-Meier survival curve.Results The dosage of remifentanil used in observation group was (98.6±24.9) mg/d, the dosage of midazolam was significantly lower than that of the control group (mg/d: 160.6±33.3 vs. 178.9±43.4, t = 2.829,P = 0.005), the incidence of delirium was obviously lower than that of the control group [22.9% (16/70) vs. 57.1% (40/70),χ2 = 15.700,P< 0.001], and the time of delirium was slightly shorter than that of the control group (hours: 162.9±78.0 vs. 194.8±117.3,t = 0.947,P = 0.348). Among the patients with delirium, the dosage of dexmedetomidine used in observation group was significantly less than that of the control group (mg/d: 0.54±0.11 vs. 0.64±0.14,t = 2.112,P = 0.041). The MAP before sedation was similar as the MAP after sedation in both groups, and there was no significant difference between observation group and control group [mmHg (1 mmHg = 0.133 kPa), before treatment: 84.7±16.2 vs. 89.5±37.7, after treatment: 82.3±10.7 vs. 80.8±13.9, bothP> 0.05]. There was no significant difference in the time of waking-up between observation group and control group (hours: 2.3±0.9 vs. 2.4±0.8,t = 0.487,P = 0.627). The duration of mechanical ventilation (hours: 143.4±138.3 vs. 163.9±158.9, t = 0.812,P = 0.418), the length of ICU stay (days: 8.8±7.7 vs. 10.0±7.8,t = 0.917,P = 0.361) and 28-day fatality rate [11.4% (8/70) vs. 20.0% (14/70),χ2 = 1.941,P = 0.245] in observation group were slightly lower than those of the control group without significant difference. Kaplan-Meier survival curve showed that the cumulative 28-day survival rate in observation group was slightly higher than that of control group (χ2 = 1.647,P = 0.199). ConclusionAnalgesia based on sedation may reduce the occurrence of delirium and its severity, furthermore, even if delirium occurs, it may be less severe.

Objective To study the serum levels of homocysteine(Hcy) and the polymorphism of C677T mutation of methylenetetrahydrofolate reductase (MTHFR) gene in pregnant women to explore their role in the pathogenesis of pre-clampsia. Methods Fifty pregnant women with preclampsia (study group) including 14 mild pre-eclampsia and 36 severe pre-eclampsia and 40 healthy ones (control group) were selected. Hey concentration was determined by fluorescence polarization immunoassay. The mutations of the 677C→T and 1298A→C of MTHFR were investigated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The mean level of plasma Hey in the study group was higher than that of control 1(12. 00±4. 59) μmol/L vs (7. 85:1:1.51) μmol/L, P<0.05], and that of the severe pre-eclampsia group was higher E(13. 30±2. 06) μmol/L, P<0. 01]. However, no significant difference was found between the control and the mild pre-clampsia group[(8. 63±3. 94) μmol/L, P>0.05]. There was significant difference in the genotype frequencies of MTHFR 677CT, TT genotype(C/T:42.0% ;T/T:14. 0%)and the total frequency of mutant T (T: 35.0%) allele between the study and control groups (P < 0. 05). Conclusions Hyperhomocysteinemia plays an important role in the pathogenesis of pre-clampsia. The polymorphism of MTHFR C677T might be associated with the development of pre-clampsia as it affects the metabolism of Hey.

Adult ; Aged ; Aged, 80 and over ; Blood Viscosity ; drug effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemorheology ; drug effects ; Humans ; Male ; Middle Aged ; Phytotherapy ; Pulmonary Heart Disease ; blood ; drug therapy

ATP-Binding Cassette, Sub-Family B, Member 1 ; biosynthesis ; Animals ; Brain ; metabolism ; Disease Models, Animal ; Glycoproteins ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Status Epilepticus ; metabolism

Objective To investigate the effect and perioperative nursing experience of surgical operation on patients with incomplete cervical spinal cord injury caused by traumatic cervical spine fracture. Method Fifty-nine patients with traumatic cervical spine fracture in our hospital from January 2011 to 2014 were nursed perioperatively, including before operation , training accttenty with swallowing and blowing balloons besides basic nursing care , and after operation , mental care , close observation and functional exercises postoperatively. Results The operation time was (110.5+13.0) min, the amount of bleeding was (155.6+7.5)mL. Three patients developed hematoma compression, 13 patients developed high fever. All patients were cured after treatment and nursing. Conclusion Preoperative training of swallowing and blowing balloon is fundamental for ensured surgical effect and intraoperative surgical cooperation and close observation together with postoperative mental care, close obsersation and functional exercise are the guarantee for surgical effect.