Unplanned extubation (UEX) is defined as premature removal of the indwelling catheter tube by a patient (deliberate unplanned extubations) or by staff during nursing and medical care (accidental extubations). UEX, either deliberate or accidental, can cause severe damage of patients, with the increasing of hospital costs and medical disputes. Identifying high-risk patients is the key point of reducing UEX. This review conclude risk assessment tools reported for UEX.

Objective To calculate the biological reference of plasma amino acid on L-8900 amino acid analyzer and to provide reference for clinical diagnosis with domestic reagents replacing original reagent .Methods By testing the original standards and the same batch of plasma (50 cases) ,we compared original reagents with domestic reagents for their performance (including resolution , repeatability ,accuracy ) .We tested the plasma free amino acids of 400 cases of healthy people using the domestic reagents to estab-lish biological reference interval of plasma amino acid ,and do correlation analysis between the amino acids level and liver function . Results (1)Domestic reagents showed high accuracy in the results of 5 consecutive detection of amino acids were high peak separa-tion and high peak retention time and high peak area .(2)Statistics derived biological reference interval of 19 amino acids and 10 kinds of amino acids had significant differences .(3)Correlation analysis showed that ALT and liver function were negatively corre-lated with threonine(P<0 .05) .GLU and valine ,isoleucine ,leucine were positively correlated(P<0 .05) .CHO and negatively cor-related with isoleucine(P<0 .05) .Conclusion Domestic agents can replace the original reagents ,on the basis ,the biological refer-ence intervals of plasma amino acids have great importance to clinical diagnosis and prognosis .

Objective To detect the change of interleukin-18 (IL-18) level in the serum of patients with acute leukemia (AL) in children, and explore the clinical significance of IL-18. Methods The level of IL-18 was measured by sandwich enzyme-linked immuno-sorbent assay (ELISA) in 45 patients with AL in children. Results The leverof IL-18 in pre-treatment AL group was 719.35±358.21pg/mL and significantly higher than that of normal-control group [(311.80±146.64)pg/mL P <0.01]. Mter treatment, the level of IL-18 was 401.14±180.78 pg/mL in post-treatment complete remission group, which was significantly lower than that of pre-treatment group(P <0.01). The level of IL-18 in non-remission group was higher than those of normal control and CR group (P<0.01);while pre-treatment group the difference was not significant (P >0.05). According to the clinical sub-group with risk factors in pre-treatment AL, the level of IL-18 in high risk(HR) and middle risk(MR) group was significantly higher than low risk(LR) group (P<0.05). The level of IL-18 in T-ALL group was significantly higher than that in B-ALL group (P<0.05). The levels of IL-18 in pre-treatment AL were markedly correlated to the count of blast cells in bone marrow (r=0.411, P=0.005). Conclusion The level of IL-18 in the patients of childhood AL was in a high expression, and related to the clinical treating effect and the count of blast cells in bone marrow, which would be taken as an index of treating effect. The level of IL-18 was closely related to the clinical risk factors in pre-treatment AL.

A robust,selective and highly sensitive chemiluminescent (CL) platform for protein assay was presented in this paper.This novel CL approach utilized rolling circle amplification (RCA) as a signal enhancement technique and the 96-well plate as the immobilization and separation carrier.Typically,the antibody immobilized on the surface of 96-well plate was sandwiched with the protein target and the aptamer-primer sequence.This aptamer-primer sequence was then employed as the primer of RCA.Based on this design,a number of the biotinylated probes and streptavidin-horseradish peroxidase (SA-HRP) were captured on the plate,and the CL signal was amplified.In summary,our results demonstrated a robust biosensor with a detection limit of 10 fM that is easy to be established and utilized,and devoid of light source.Therefore,this new technique will broaden the perspective for future development of DNA-based biosensors for the detection of other protein biomarkers related to clinical diseases,by taking advantages of high sensitivity and selectivity.

A robust, selective and highly sensitive chemiluminescent （CL） platform for protein assay was presented in this paper. This novel CL approach utilized rolling circle amplification （RCA） as a signal enhancement technique and the 96-well plate as the immobilization and separation carrier. Typically, the antibody immobilized on the surface of 96-well plate was sandwiched with the protein target and the aptamer-primer sequence. This aptamer-primer sequence was then employed as the primer of RCA. Based on this design, a number of the biotinylated probes and streptavidin-horseradish peroxidase （SA-HRP） were captured on the plate, and the CL signal was amplified. In summary, our results demonstrated a robust biosensor with a detection limit of 10 fM that is easy to be established and utilized, and devoid of light source. Therefore, this new technique .will broaden the perspective for future development of DNA-based biosensors for the detection of other protein biomarkers related to clinical diseases, by taking advantages of high sensitivity and selectivity.

Aim ToconstructHEK293cellsstablyex-pressing corticotropin releasing factor receptor 1 ( CRFR1 ) , and evaluate its function by the cAMP as-say.Methods CulturedHEK293cellsweretransfect-ed with CRFR1-expressing vector by Lipofectamine 2000 and were selected by using G418 . CRFR1 ex-pression was detected by Western blot, RT-PCR and immunofluorescence.Results Westernblot,RT-PCR and immunofluorescence data revealed that the HEK293 cells expressed CRFR1 protein stably. The dose-responsive relationship experiment revealed that CRF induced a CRFR1-mediated cAMP production in HEK293 cells with EC50 =(5. 64 ± 0. 05) × 10 -10 mol ·L-1.Conclusion HEK293celllinesstablyex-pressing CRFR1 were constructed successfully, which would provide a cellular model to facilitate the research on the biological function of CRFR1 and CRFR1-targe-ted drug screening.

Aim To study the effect of EA on the injury induced by ?-amyloid protein(A?) in primary cultures of rat hippocampal neurons. Methods The protective effect of EA on A?_25-35 induced neurons injury was observed by LDH release rate, MTT, LSCM and TUNEL. Results A?_25-35 could induced cell death in rat primary hippocampal neurons. Four hours pretreatment with 20 mg?L-1, 40 mg?L-1 EA exerted the protective effect on rat primary hippocampal neurons from A?_25-35 induced injury. Conclusion EA had protective effects against injury induced by A?_25-35 in rat primary hippocampal neurons to some certain,which probably related with decreasing the level of calcium.

Objective To prepare a completely biological hybrid scaffold for small-diameter vascular tissue engineering using porcine fibrin and decellularized canine carotid artery.MethodsPorcine fibrin was sprayed coating on the external surface of decellularized canine carotid artery to construct completely biological hybrid scaffold for small-diameter vascular tissue engineering. The completely biological hybrid scaffold was evaluated with Hematoxylin and Eosin (H&E) staining, scanning electron microscopy and biomechanics test.ResultsHistology examination revealed that the porcine fibrin was sprayed coating uniformly on the external surface of decellularized canine carotid artery. Scanning electron microscopy examination confirmed that the external surface of completely biological hybrid scaffold was smooth and uniformly. Compared with fresh canine carotid artery and decellularized artery, the biological hybrid scaffold had similar burst and breaking strength. Furthermore, compared with decellularized artery, the biological hybrid scaffold had higher compliance.ConclusionThe porcine fibrin was sprayed coating uniformly on the external surface of decellularized canine carotid artery to prepare a completely biological hybrid scaffold for small-diameter vascular tissue engineering. The biological hybrid scaffold had appropriate biomechanical properties and had potential to serve as scaffolds for small-diameter vascular tissue engineering.

Objective To establish an ultraviolet-irradiation damage model in cultured fibroblasts derived from human skin and to explore the potential protective effects and mechanisms of amyloid precursor protein 17-met peptide (APP17-mer peptide) on the oxidative damage and collagen metabolism in cultured fibroblasts after ultraviolet irradiation. Methods Human dermal fibroblast cultures were established by outgrowth from foreskin biopsies of a healthy donor and were irradiated by a single exposure to ultraviolet rays and cultured in a series of concentrations of APP17-mer peptide (0, 20, 40, 80 μmol/L).The activity of fibroblasts was detected by the assay of MTT. The intracellular ROS level was measured with a confocal microscope. The expression of MMP-1 mRNA was analyzed real-time quantitatively following RT-PCR. Results Primary cultures of human skin fibroblasts were established from human foreskin in DMEM supplemented with 10 % fetal bovine serum. UV irradiation depressed cellular activity and increased intracellular level of ROS (P<0.05). 40μmol/L and 80μmol/L APP17-mer peptide increased the cellular activity in both UV irradiated fibroblasts and unirradiated fibroblasts (P<0.05), however,20 μmol/L did not show such protective effects (P>0. 05). 40μmol/L APP17-mer peptide could depress the level of ROS in irradiated libroblasts. A single exposure of fibroblasts to UV irradiation resulted in 1.78 foldup-regulation of MMP-1 mRNA compared with unirradiated sample, 40μmol/L and 80μmol/L APP17-mer peptide decreased the expression of MMP-1 mRNA (P<0.05 and P<0.01, respectively).Conclusion APP17-mer peptide can enhance cellular activity under UV-induced oxidative stress and in-hibit collagen degradation in fibroblasts irradiated with ultraviolet rays. Inhibition of ROS production may be involved in the protective mechanism of APP17 peptide.

Objectives To assess the plasma levels of acyl ghrelin (AG) and dys-acyl ghrelin (DG) in chronic kidney disease (CKD) and hemodialysis (HD) patients and analyze their relationships with different stages of CKD and hemodialysis. Methods Forty-six CKD stage 1-5 patients and 15 hemodialysis patients were enrolled into the study. Body weight, height, hemoglobin, biochemical parameters, inflammatory parameters, preprandial, postprandial and 3 hours after hemodialysis plasma AG and DG levels were measured. Appetite and food intake were assessed. Body mass index (BMI), and estimated glomerular filtration rate (eGFR) were calculated. Results There were no significant differences in BMI, SGA, appetite, food intake and malnutrition among CKD patients of different stages. eGFR was declining with the progression of CKD stages and patients received a three-week hemodi-alysis. Compared with that in CKD stage 1-2 patients, the level of preprandial and postprandial DG was remarkably increased in stage 3-5 patients (P<0.01). The level of DG was significantly decreased after a standard breakfast in CKD patients (P<0.01). CKD stage was positively correlated with preprandial (r=0.31, P<0.05)a nd postprandi-al DG (r=0.34, P < 0.05), TNF-α (r=0.33, P < 0.05), IL-6 (r=0.40, P < 0.05), leptin (r=0.34, P < 0.05), and age (r=0.41, P<0.05). CKD stage was also highly and positively correlated with the proportion of preprandial and postprandial DG (r=0.61, P<0.01;r=0.55, P<0.01). Multivariate partial-correlation analysis showed that CKD was independently associated with the proportion of preprandial and postprandial DG (r=0.55, P < 0.01; r=0.43, P < 0.01).There was no decrease in AG postprandially, nor any changes in AG resultant from dialysis (P > 0.05);levels of DG decreased slightly postprandially and were markedly decreased by hemodialysis (P<0.01), even lower than those seen postprandially in CKD stage 1-2;Both preprandial and postprandial DG were negatively correlated with serum albumin levels (r=-0.64, P < 0.05; r=-0.59, P < 0.05), while there was no correlation between AG and serum albumin levels. Conclusions There is a strong and independent correlation of DG with CKD stage. Postprandial suppression of ghrelin is impaired with reduced renal function. Hemodialysis removes DG but not AG.