Objective To evaluate the effects of limited fluid resuscitation on septic shock caused by myocardial injury . Methods 60 severe traumatic sepsis and septic shock patients were randomly divided into study group and control group ,with 30 cases in each group ,the control group was given active fluid resuscitation ,maintain the mean arterial pressure (MAP) in 70 mm Hg ;the study group were treated with limited fluid resuscitation ,namely when MAP rose to a slow infusion rate 50-60 mm Hg ,we restrict the amount of fluid ,maintain MAP at about 50 mm Hg ,observe and record the two groups of patients hemodynam-ics index ,APACHE Ⅱ score and heart function index ,and compared serum cTnI ,NT proBNP and CRP in the two groups .Results (1)In study group the infusion volume before admission was (258 ± 105)mL ,preoperative was (558 ± 226)mL ;in the control group that of before admission was (816 ± 422)mL ,preoperative was (1 668 ± 780) mL (P<0 .05) .The mortality rate in study group was 13 .3% ,the mortality in control group rate was 26 .7% (P<0 .05) .(2) the HR and blood lactic acid levels in two groups decreased significantly after treatment ,MAP and CVP increased significantly (P<0 .05);there were no significant differences in hemodynamic parameters (P>0 .05) .(3)After the treatment APACHEⅡscore of the two groups was significantly decreased ,car-diac output ,stroke volume and left ventricular ejection fraction significantly increased in control group ,the study group were better than control group (P<0 .05) .(4) The plasma cTnI ,NT proBNP ,CRP levels of the two groups significantly decreased after treat-ment (P<0 .05) ,plasma cTnI ,NT proBNP and CRP levels of research group were significantly lower than that of control group (P<0 .05) .Conclusion Limited fluid resuscitation can maintain hemodynamic ,reduce the interference on the internal environment ,re-duce myocardial injury ,and improve the success rate of treatment .

0.05),but all statistically distinguishable from fresh allografts(P

Objective To approach work pressure and its influencing factors in general surgical nurses. Methods 105 general surgical nurses were selected from 8 hospitals with stratification clus-tering randomization methods. The job stressor inventory,- personality scale, coping styles questionnaire and general state of health questionnaire were used to carry out investigation and the results underwent analysis. Results The main stressors came from the factor of workload and time allocation, then from nursing specialty and job. Working time more than 10 years, undergraduate degree or above, work shift, neuroticism, wrapping, avoidance, letting off were risk factors of work pressure in general surgical nurses. Age more than 40 years old, nurse and associate director, exotrophy, planning to solve the ques-tions, seeking social support, rational coping were protective factors of work pressure for nurses. Con-clusions The overall pressure level of general surgical nurses was moderate. We should cultivate favourable personality of nurses and positive coping styles in combination with their demography char-acters to prevent work pressure.

Objective To investigate the effect of predictive nursing on the living donor liver transplantation.Methods Forty patients undergoing living donor liver transplantation were divided into the intervention group and the control group with 20 patients in each group randomly.We gave routine nursing cooperation to the control group while predictive nursing besides routine nursing cooperation to the intervention group.The operation time,cold ischemia time of donor liver,nursing complication,cost of surgery and satisfaction degree of surgery cooperation were recorded.Results Compared with the control group,the operation time,cold ischemia time of donor liver,nursing complication,cost of surgery were all decreased,and the satisfaction degree of surgery cooperation was improved.Conclusions Predictive nursing can improve nursing operation quality,raise the efficiency of nursing and surgery,reduce the incidence of complication,which is beneficial to smooth progress of operation and increase satisfaction degree of doctors and nurses to nursing cooperation.

To compare the expression level of metastasis associated-1 (MTA1) gene in high and low metastatic human osteosarcoma cell lines and examine the relationship of MTA1 expression and the metastasis potentiality of osteosarcoma cells, the expression of MTA1 in MG-63 osteosarcoma cell lines with high and low metastasis potential was detected by semiquantitative TR-PCR. Boyden chamber invasion assay was used to evaluate the invasive capacity in vitro in two osteosarcoma cell lines. The low metastasis MG-63 cells were transfected with MTA1 full-length cDNA expression plasmid by lipofectamine and the changes of MTA1 expression and in vitro invasion potential were examined after the transfection. Our results showed that MG63 cell line with high metastasis potential expressed significantly higher MTA1 than that of MG63 cells with low metastasis as reavealed by RT-PCR. The invasion potential of low metastasis MG63 cell line was increased after MTA1 gene transfection. It is concluded that there may be a relationship between MTA 1 and invasive potentiality of human osteosarcoma cells, and the mechanism of MTA1 in osteosarcoma metastasis and its possible role in associated gene therapy deserve further study.
Bone Neoplasms/*metabolism ; Bone Neoplasms/pathology ; Gene Expression Regulation, Neoplastic ; Histone Deacetylases/*biosynthesis ; Histone Deacetylases/genetics ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Osteosarcoma/*metabolism ; Osteosarcoma/pathology ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Repressor Proteins/*biosynthesis ; Repressor Proteins/genetics ; Tumor Cells, Cultured

Objective To research the influences of gambogic acid on rats'cytochrome P450 isoforms by using the Cocktail probe drugs. Methods Rats were randomly divided into several groups. One group of rats received gambogic acid solution containing 0.5 %CMC-Na (2 mg?mL-1,once per day) orally for six days. At the same time,the rats in the other group received 0.5 %CMC-Na solution serving as blank control group. Blood samples were collect at different time point,and the plasma concentration of cocktail probe drugs was determined by HPLC. Results There was insignificant difference of caffeine and dapsone metabolism between the gambogic acid group and the blank group,but the chlorzoxazone was eliminated faster in the gambogic acid group,and the half life of chlozoxazone was shorter. Conclusion Gambogic acid has no significant influence on the cytochrome P450 isoforms of CYP1A2 and CYP3A4,but has an induction on the CYP2E1.

AIM To explore whether plasma vasoactive substances and neutrophil infiltration make different contribution in cerebral ischemia-reperfusion injury and protective effect of triacetylshikimic acid(TSA). METHODSThe rat models of ischemia 90 min and reperfusion 3-48 h were prepared with middle cerebral artery occlusion. TSA 50-200 mg·kg-1 were given (ig) immediately and 60 min again after the onset of ische- mia. Serotonin and thromboxane B2 (TXB2) concentrations in plasma were detected by fluorescence spectrophotometry and radioimmunoassay respectively. Myeloperoxidase(MPO) activity in brain tissue was quantified by chemical analysis. RESULTS At 3-24 h after reperfusion, the concentrations of plasmic serotonin, TXB2, and brain MPO activity increased obviously in a time-dependent manner. At 48 h after reperfusion, the concentrations of serotonin and TXB2 decreased to the same level of sham. Nevertheless, brain MPO activity remained more elevated than the contralateral cortex. At 24 h after reperfusion, TSA (100 and 200 mg·kg-1) was shown to possess the ability to inhibit the increased plasmic serotonin, TXB2 concentrations, and brain MPO activity induced by focal cerebral ischemia-reperfusion. CONCLUSION Vasoactive substances in plasma and MPO activity in brain tissue show different time courses during focal cerebral ischemia-reperfusion and make different contribution to brain damage. TSA is effective to protect the ischemic brain tissue from ischemia-reperfusion injury.

ObjectiveTo explore the early effects of transplantation of fetal spinal cord (FSC) and basic fibroblast growth factor (bFGF) on calcium, magnesium of injured spinal cord.MethodsThe spinal cord injury (SCI) animal model was established with Wistar rats. The rats were divided into 3 groups. The group A was received FSC cells suspension 5 ml after injury. The group B was received FSC cells suspension and bFGF 20 μl. The group C was not treated with any therapy. The values of Ca2+, Mg2+ of injured spinal cord tissues were measured at 6, 24 hours after injury. The morphyological results were observed by electron microscope on the fifth day.ResultsThe degree of ionic disorder in FSC+bFGF treated rats was strikingly ameliorated and the contents of H2O also decreased. The morphyological finding revealed that in FSC+bFGF treated rats, the damage of gray and white matters was slight in contrast to those of control group rats, which appeared a typically damage.ConclusionTransplantation of FSC and bFGF has some protective effects on contused spinal cord in rats.

BACKGROUND: For xenogeneic bone transplantation, immune rejection is the major problem that affects the prognosis. However, the understanding about the expression and regulation of the immune factors in heterogenic bone transplantation is limited. Interleukin-1 (IL-1), interleukin-6 (IL-6)and tumor necrosis factor alpha (TNF-α) are important immune factors, and are closely related with post-transplantation rejection.OBJECTIVE: To observe the regional expressions of mRNA and protein of IL-1α, IL-6 and TNF-α in xenogeneic bone transplantation, and to in vestigate the effect of transforming growth factor (TGF)-β on these immune factors.DESIGN: A randomized controlled experiment. SETTING: The Orthopaedic Institute of Xijing Hospital of the Fourth Military Medical University of Chinese PLA MATERIALS: Totally 72 male Balb/c mice, with a body mass of 20 to 25 g, were randomly divided into 3 groups: combined bovine cancellous bone (bCB) granule group (Group A), simple bCB granule group (Group B) and blank control group (Group C) with 24 mice in each group.INTERVENTIONS: This experiment was conducted at the Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical Univessity of Chinese PLA from June 2003 to June 2004. In Group A, one bCB combined TGF-β was implanted into the muscles of left thigh of each mouse. In Group B, one bCB alone was implanted, and in Group C, no bCB was implanted. The number of proliferation of cells in bone implantation area or adjacent tissues of the operated area was observed at postoperative 4, 7, 14 and 21 days; and the regional expressions of several immune factors in im plants were detected with in situ hybridization and immunocytochemistry methods.MAIN OUTCOME MEASURES: Histological observation and detection of regional cellular density of the implants of the mice in each group; the regional expressions of mRNA and protein of IL-1α,IL-6 and TNF-α in the implants RESULTS: ①) Histological observation and detection of regional cellular density of the implants of the mice in each group: on day 7, the cellular density of the proliferated tissues was significantly higher in the Group A than in the Group B [(470.63±132.89), (311.46±93.69)/field,P ＜ 0.01];But on days 14 and 21, there was no significant difference. ②The regional expressions of mRNA and protein of IL-lα, IL-6 and TNF-α of the im plants of the mice in each group. On days 7 and 14 after xenografts were implanted, the regional expressions of IL-1α, IL-6 was respectively lower the xenografts combined with TGF-βthan in the simple xenogeneic bone (day 7: IL-1α 42.55±9.65 vs 67.95±17.82,IL-6 48.26±11.17 vs 77.21±15,16;day 14: IL-1α mRNA 84.77 ±7.42 vs 112.94±7.02,78.1 ±17.22 vs 121.18±15.44,P ＜ 0.01) ,but for the TNF-α, there was no significant difference (P ＞ 0.05).CONCLUSION: In the region of bone xenograft, a variety of cells express mRNAs and proteins of IL-1α, IL-6 and TNF-α, and their expressions are regulated by TGF-β. It may imply a kind of regulation of the immunity of bone xenograft by TGF-β.

Objective:To analyze the relationship between the clinical medical college students' time investment (including study, activities, entertainment and exercise) and general self-efficacy (GSE) in a medical university in Liaoning province, China.Methods:The first-year medical students were asked to participate the survey. Their GSE was measured by using general self-efficacy scale (GSES) in 2018. One year later, the independent variable table was used to investigate the extracurricular activity time, and 683 valid questionnaires were collected. Ordered logistic regression method was used to analyze the correlation between students' extracurricular activities and GSE.Results:Medical students' GSE was positively associated with their time in extracurricular study ( OR = 1.94, 95%CI = 1.49-2.54), volunteer activities ( OR=1.36, 95%CI = 1.01-1.83), and physical activities ( OR = 1.37, 95%CI = 1.01-1.85). However, there was no significant correlation with the time in activities organized by students ( OR = 1.09, 95%CI = 0.79-1.50) or activities organized by school ( OR = 1.15, 95%CI = 0.84-1.59). Furthermore, compared with clinical students of "5+3" year program, the 5-year program clinical students had a stronger correlation between medical students' GSE and the input of extracurricular study time. Conclusion:There is a positive correlation between medical students' GSE and their extracurricular time investment, which indicates that increasing medical students' GSE could be an effective method to improve their extracurricular time investment and eventually improve their comprehensive quality.