Objective To evaluate the therapeutic effect of lamivudine in the treatment of HBV-related liver failure.Methods We collected the literature on lamivudine used to treat liver failure in randomized control trail or clinical control trial studies from January 1989 to July 2007.All these clinical trials were carried out by comparing lamivudine treatment with routine medical treatment for liver failure.The literature must concern about mortality,total bilirubin(TBIL)or prothrombin activity(PTA).Odds ratio(OR)was applied to evaluate the effect of glucocorticoid to improve case fatality.Weighted mean differences(WMD)was applied to evaluate the effect of lamivudine to improve TBIL and PTA.Results There were only 13 literatures obtained,among them all about mortality,and 10 about TBIL and PTA.Effective index was 0.29(95%CI:0.21,0.40),-0.88(95%CI:-1.27,-0.48)and 0.60(95%CI:0.42,0.78)respectively for the 3 indexes.Conclusion Combination with lamivudine is more effective in treatment liver failure than only routine medical treatment.

Objective To investigate the reliability and validity of Hospice care quality assessment scale. Methods Eight experts in the field of hospice revised the Scale after Chinese localization. The scale data were analyzed after collation of 181 families fulfill the scale. Results The total scale Cronbach′s a coefficient was 0.851. The first dimension′s coefficient was 0.796. The second dimension′s coefficient was 0.622 and the third dimension′s coefficient was 0.827. In factor analysis of the scale, after varimax rotation, the number of characteristic roots>1 was 10 and made up of 70.88%of the total variance. Conclusions The hospice care quality assessment scale after Chinese localization has good reliability and validity and could be a tool to evaluate the clinical quality of care for dying patients.

Detection of epileptic waves in EEG is particularly helpful in the interpretation of the underlying process in seizures. This study is aimed at providing a new method for automatic detection of epileptic waves through the wavelet analysis of EEGs. It mainly deals with the detection of spikes or spike-waves based on wavelet transform. Since spikes and spike-waves contain high frequency energy, they will be represented in a particular scale localized in a small time window. According to these feature waveforms of epileptic waves, a continuous processing system for epileptic waveforms detection is constructed. We apply discrete wavelet transform on EEGs. Because of the time-frequency domain localization of wavelet transforms, we can get the local maximal positions across several successive dyadic scales of wavelet transform. And these positions indicate the points of sharp transitions in EEGs. Then we calculate the distance between every two successive maximal positions in each scale. This distance stands for the period of subwave. Furthermore, the distribution of subwave periods of each scale can be worked out. Then, comparing the distribution of normal EEG's and epileptic EEG's. The difference between these two waveforms provides us the criteria for automatic detection and classification. In order to reduce the detection workload, we also compare the detection efficiency of each scale. The scale that provides highest accuracy is selected for our automatic detection system. The results presented in this study show that scale 3 provides the best detection accuracy. So, scale 3 is deemed to be the proper scale for automatic detection. This system has the following advantages: (1) Reduced the workload significantly by selecting proper scale(s) for automatic selection; (2) Enhanced the detection accuracy by selecting proper criteria and threshold; (3) Capable of continuous detection; (4) It is also fit for the detection of other biomedical signals. This system showed good performance, and the initial clinical results obtained are also encouraging.
Electroencephalography ; Epilepsy ; diagnosis ; Humans ; Wavelet Analysis

[Objective]To investigate the protective effect of Tanshinone IIA (TSⅡA) against interleukin-1β (IL-1β) induced obstruction of energy metabolism of rabbit annulus fibrosus cell in vitro.[Methods]Rabbit annulus fibrosus (AF) cells were cultured in 3-dimension alginate beads and randomly divided into 7 groups. Various concentrations of TSⅡA and IL-1β was added to the medium for intervention: no drug was added in group A as normal control, 4 μg/ml TSⅡA in group B, 10 μg/ml IL-1β in group C, and both 10 μg/ml IL-1β and different concentrations of TSⅡA in groups D-G (0.5 μg/ml, 1 μg/ml, 2 μg/ml and 4 μg/ml respectively). After 3 days of incubation, the cells were collected for measuring the activity of Na+-K+-ATPase and succinate dehydrogenase (SDH), MTT assay for cell proliferation, and AnnexinⅤ-PI staining for cell apoptosis.[Results]The activity of Na+-K+-ATPase of group G (10 μg/ml IL-1β+4μg/ml TS IIA; 3.23±0.28 U/mgprot) was increased significantly as compared with group C (10 μg/ml IL-1β; 1.118±0.15 U/mgprot, P＜0.01). The activity of SDH of group G was 12.48±0.97 U/mgprot, which was obviously higher than that of group C (3.03±0.60 U/mgprot, P＜0.01). The absorbance of MTT assay of group G (0.77±0.06) was significantly increased as compared with group C (0.31±0.07,P＜0.01). The absorbance of groups D-G increased as the concentration of TSⅡA increased. The apoptotic cell rate and dead cell rate of group G was 21.08±1.46% and 8.99±0.33%, which were both lower than that of group C (43.11±2.7,P＜0.01 and 11.71±0.32,P＜0.01).[Conclusion]TSⅡA is able to promote cell proliferation and decrease cell apoptosis of AF by alleviating IL-1β induced inhibition on cell energy metabolism.

Objective To develop a Chinese version of Frommelt Attitude Toward Care of the Dying scale (FATCOD) and evaluate its validity and reliability to provide a tool for the field of hospice care and death education used among nurses.Methods FATCOD scale was adopted according to Brislin's translation model for cross-cultural research and its reliability and validity of the new Chinese version was tested in 126 nurses.Factor analysis and correlation analysis were applied to establish the validity and reliability.Results The Chinese version of FATCOD scale consisted of 30 items.The Cronbach's α coefficient of the scale was 0.828; split-half coefficient of the whole scale was 0.807; the varimax rotation factor analysis of the scale identified twelve principal factors and explained for 69.5％ variances.Conclusions The Chinese version of FATCOD scale is valid and reliable in the sample of nurses,and can be used in the field of hospice care and death education.

Objective To evaluate the therapeutic effect of low-dose,ultra-low-dose and standard dose chemotherapy for elderly acute myeloid leukemia.Methods A retrospective analysis was performed on 77 elderly AML patients aged 60 years or older.The short-term and long-term effects were compared among low-dose,uhtra-low-dose and standard-dose chemotherapy.Results Although patients receiving low-dose or ultra-low-dose chemotherapy were older,with higher PS scores and lower WBC count,there were no significant differences in CR rate,ORR,EFS or OS between patients who received low-dose/ultra-low-dose chemotherapy and standard-dose chemotherapy.By dividing the total samples into subgroups according to age or PS scores,we found out that patients younger than 70 or with a PS score less than 2 showed a much better prognosis,no matter short-term or long-term,in low-dose／ultra-low-dose group rather than in the standard dose group.While in those patients older than 70 or with a PS score more than 2,the differences between those two groups were not significant.Further analysis showed that low-dose chemotherapy did not reduce treatment related mortality,neither did it increase the risk of long-term relapse.Conclusion Low-dose and ultra-low-dose chemotherapy can improve the prognosis of elder AML patients compared with standard-dose chemotherapy,especially for elderly patients who have a better general state.

In order to investigate the apoptotic pathway of rabbit annulus fibrosus (AF) cells induced by mechanical overload, an experimental air-pressure model was established in this study to pressurize the rabbit AF cells in vitro. Cells were randomly divided into five groups in which the cells were exposed to a continuous pressure of 1.1 MPa for different lengths of time (0, 5, 12, 24 and 36 h). The cell proliferation and apoptosis were detected by cell counting kit-8 (CCK-8) assay and flow cytometry; the alterations in mitochondrial membrane potential were measured by fluorescence microscopy and fluorescence spectrophotometer; the activities of caspase-8 and 9 were determined by spectrophotometry. The results showed that after the cells were subjected to the pressure for 24 or 36 h, the cell proliferation was inhibited; the ratio of cell apoptosis was increased; the mitochondrial membrane potential was decreased; the activity of caspase-9 was enhanced; no activity changes were observed in caspase-8. The results suggested that treatment with a pressure of 1.1 MPa for more than 24 h can lead to the proliferation inhibition and the apoptosis of rabbit AF cells in vitro, and the mitochondrial-dependent pathway is implicated in the pressure-induced AF cell apoptosis.

Background Nanoemulsions (NEs) is one of the most popular ophthalmic colloidal drug delivery system due to its long-term stability, low toxicity and irritancy, considerable capacity for solubilization of lipophilic drug molecules and great potential in bioavailability improvement.The cornea pathway is the main route of intraocular absorption after topical use of NEs.Though NEs possess numerous physiological and physicochemical advantages,the use of NEs cannot always obtain satisfactory results.Objective This study was to investigate the impacts of epithelium and stroma on the corneal permeation of topical ophthalmic terbinafine hydrochloride nanoemulsions (TH-NEs).Methods TH-NEs was prepared by the self-emulsification method.The size and Zeta potential of the oil droplets in the formulation were analyzed using a dynamic light-scattering particle size analyzer.The high performance liquid chromatography (HPLC) was used for the in vitro release study.Sixty New Zealand albino rabbits were randomly divided into intact cornea group and cornea epithelium debrided group.The cornea epithelium of the left eyes was debrided in the cornea epithelium debrided group.The TH-NEs were instilled into the lower conjunctival sac of left eyes.Six rabbits were executed from each group 15,30,60,120 and 240 minutes after dosing,respectively.The corneas were collected and analyzed by HPLC.The fluorescein diacetate (FDA) was used to label the TH-NEs.Two C57BL/6 mice with left cornea epithelium debrided and 2 normal mice were used for the fluorescence tracing study.The fluorescence distribution of FDA labeled TH-NEs was observed by a two-photon laser confocal scanning microscope 30 minutes and 60 minutes after single instillation.Results The average size and Zeta potential of the oil droplets were 51.37 nm and-0.232 7 mV respectively,and 0.482％ of encapsulated drugs was released from the TH-NEs after 12 hours.The peak concentrations of TH in the intact cornea and epithelium debrided cornea were (17.85 ± 2.79) μg/g and (4.40± 1.75) μg/g respectively, which occurred 15 minutes postdose.The drug concentrations in the intact cornea were significantly higher than that in the debrided cornea 15,30,60 and 120 minutes after dosing, with significant differences between them (t =9.998,8.658,6.903,7.576;all at P=0.000).The fluorescence was observed in the cornea epithelium when the cornea was intact.The fluorescence intensity in the superior layer of corneal epithelium was obviously higher than that in the deep layers of corneal epithelium 30 minutes and 60 minutes after dosing.No fluorescence was observed in the cornea stroma of both eyes.Conclusions The cornea epithelium is the main of absorption and distribution position of TH-NEs.The cornea stroma is the dominating permeation barrier for the intraocular transportation of the TH-NEs.The cornea stroma may stop the permeation of TH-NEs by molecular exclusion mechanism.

Objective To explore what symptoms which the medical staff judged from determination of agonal symptoms in cancer patients. Methods Focus group interview was conducted by 3 groups, 5 people in each group in appropriate time and place at May 2015. The interview was conducted around the theme of"how to judge the advanced cancer patients in dying". Results Agonal patients often showed changes in 7 aspects by content analyzing included pain, "the last radiance of the setting sun", consciousness, breathing patterns, blood circulation, intake and output volume and functional status. Besides, the instinct and experience of medical staff was another determinant. Conclusions Medical staff members have their qualitative understanding on evaluating when cancer patients are agonal. Changes in some symptoms before death can provide references for evaluating survival time.

Background Macrogol 15 hydroxystearate (HS15) is a novel soft non-ionic surfactant and is widely used to solubilize the poorly soluble drugs due to high drug loading and enhancing permeability ability to hydrophobic drug.However,the delivering effects to cornea of HS15 on terbinafine hydrochloride (TH),a insoluble antifungal agents,is unclear.Objective This study was to investigate the promoting corneal absorption effects of HS15 micelles (HNMs) on TH.Methods TH-HNMs was prepared by a co-solvent method.The hydrodynamic droplet size,polydispersity index,and Zeta potential of TH-HNMs were measured by using a Zetasizer.The shape of the micelles was observed under the transmission electron microscope.The high performance liquid chromatography (HPLC) was employed to detect the in vitro cumulative releasing level of TH in the TH-HNMs and drug entrapment efficiency.TH-HNMs was topically adninistered in eyes of 5 healthy male New Zealand rabbits to evaluate the ocular irritation response.Ninety rabbits were randomized into experimental group and control group,and 50 μl of 0.5％ TH-HNMs and 0.5％ oily TH were topically administered in the right eyes of the animals in the experimental group and contral group,respectively.The animals were sacrificed 5,15,30,60,90,120,180,240,360 minutes after eye dropping by over anesthetization way and the corneas were harvested,and the TH content in the cornea was detected using HPLC.The study protocal was approved by Life Science Ethic Committee of Henen Eye Hospital.Results The average size and polyolis persital index of TH-HNMs were 13.32 nm and 0.046,respectively,and its average Zeta potential was-0.133 mV.The drug entrapment efficiency was 100％.The release level of TH from the micelles presented a pH-dependent manner.The release level of TH was (95.20±3.20)％ in the phosphate buffer with pH 5.0 and (0.17± 0.01)％ in the phosphate buffer with pH 7.4.The ocular irritation score was 2,and no visible damage was found around experimental eyes after instillation of TH-HNMs.The peak content of TH in the rabbit cornea 5 minutes was (20.26±2.26)pg/g in the experimental group,which was significantly higher than (1.40± 0.44)μg/g in the control group (t =18.926,P=0.000).The area under the curve (AUC)0.360min of drug concentration-time curve in the experimental group was 1 292.25 μg/(g · min),which was 15.6 times more than the control group.Conclusions TH-HNMs is an ideal agent with a simple preparing process,high drug entrapment efficiency,small size and low ocular irritation.Compared with oily TH,TH-HNMs can effectively enhance the corneal absorption of TH.