Objective To explore the prognostic role of nutritional benefit assessment (NUTRIC score), nutritional risk screening 2002 (NRS 2002), traditional nutritional laboratory indicators albumin (ALB) and prealbumin (PA) in critically ill patients. Methods A historical-prospective cohort study was conducted. The data of 427 patients admitted to Department of Critical Care Medicine of the Affiliated Hospital of Guizhou Medical University from February 2014 to October 2014 were retrospectively analyzed, and thereafter a follow-up of 275 critically ill patients from November 2014 to April 2015 prospectively enrolled was performed. 261 patients were enrolled finally. Patients were divided into death group and survival group according to 28-day and 90-day outcome, the baseline data, acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, NRS 2002, NUTRIC score, ALB and PA were compared between the two groups. Logistic regression analysis was used to find risk factors for 28-day and 90-day prognosis. Results ① NRS 2002 score of all the 261 patients were greater than or equal to 3 with 100% nutritional risk. The patients in NUTRIC score 5-9 group had lower ALB and PA, higher NRS 2002 score, longer mechanical ventilation time and length of intensive care unit (ICU) stay, which indicated they were more serious. ② Twenty eight-day mortality was 20.7% (54 died from 261). Compared with survival group, the patients in death group had higher APACHE Ⅱ, SOFA, and NUTRIC scores [29.00 (22.75, 34.25) vs. 24.00 (20.00, 28.00), 10.0 (8.0, 13.0) vs. 9.0 (7.0, 11.0), 6.37±1.84 vs. 5.59±1.64, all P < 0.01], and longer days from hospital to ICU admission and mechanical ventilation time in ICU [1.5 (0, 9.2) days vs. 0 (0, 4.0) days, 6.0 (4.0, 11.0) days vs. 4.2 (2.5, 7.8) days, both P < 0.05]. It was revealed by logistic regression analysis that APACHE Ⅱ score [odds ratio (OR) = 1.089, 95% confidence interval (95%CI) = 1.039-1.141, P = 0.000] and days from hospital to ICU admission (OR = 1.042, 95%CI = 1.014-1.071, P = 0.003) were the independent risk factors for 28-day death in critically ill patients. ③ Ninety-day mortality was 42.5% (111 died from 261). Compared with the survival group, the death group patients were older with higher APACHE Ⅱ, SOFA, NRS 2002, and NUTRIC scores [age (years): 64.44±18.11 vs. 54.25±19.66, APACHE Ⅱ: 27.00 (23.00, 31.00) vs. 23.00 (20.00, 27.00), SOFA: 10.0 (8.0, 12.0) vs. 9.0 (7.0, 11.0), NRS 2002: 5.08±1.47 vs. 4.67±1.41, NUTRIC: 6.32±1.58 vs. 5.33±1.68], ALB was significantly reduced [g/L: 27.70 (23.05, 32.00) vs. 30.73 (26.90, 34.20)], and mechanical ventilation time in ICU was extended obviously [days: 5.7 (3.6, 11.0) vs. 3.9 (2.4, 7.0), all P < 0.05]. It was revealed by logistic regression analysis that old age (OR = 1.019, 95%CI = 1.002-1.037, P = 0.029) and NUTRIC score (OR = 1.211, 95%CI = 0.983-1.491, P = 0.072) were the independent risk factors for 90-day death probability, and ALB probability was the protect factor for 90-day death (OR = 0.954, 95%CI = 0.916-0.994, P = 0.024). Conclusion It was NUTRIC score but not NRS 2002, ALB and PA predicted 90-day mortality in critically ill patients.

Objective To study the clinical, imageological and pathologic characters of primary synovial chondromatosis of hip joint, and effect of open surgery. Method 12 cases of primary synovial chondromatosis of the hip joints admitted from May 1973 to May 2004 were retrospectively studied in respect to clinical manifestations, X-ray picture, and pathological findings. The effects of operation were followed up. Results Intermittent pain, swelling, limitation of hip joints were the main complaints. Mass and myatrophy near involved hip joint were discernible in a few patients. Although there was no obvious image of calcification, swelling of articular capsule was seen in X-ray film in 4 patients. CT scan showed arthroedema, loose bodies and bone erosion of the femoral head in the hip joint. The X-ray films of the other 8 patients showed obvious calcified loose bodies. All cases were diagnosed by pathology after operations. 8 cases were categorized Milgram Ⅱstage, and 4 cases Milgram Ⅲ stage. Eight patients were followed-up for a period of 1 to 7 years (mean 5 years). Recurrence occurred in 2 cases. Conclusion The diagnosis should be based on clinical characters, X-ray films and pathologic findings, and the pathology is most reliable. In order to decrease recurrence, CT or MRI examinations should be taken before the operation. X-ray monitoring should be carried out during the operation of the patient in whom loose bodies were found in X-ray film before the operation.

Benzene ; poisoning ; Chronic Disease ; Female ; Humans ; Middle Aged ; Occupational Diseases

Objective To approach the effective treatment for simple bone cyst in adult. Methods Forty-eight cases were divided into two groups by visiting order, 20 cases (steroid group) were treated by prednisolone acetate and 28 cases (open resection and allograft group) were treated by open resection and allograft. The curative effect were contrasted between two groups. Results The follow-up time was 5-46(26.58 ± 10.81) months. Aecording to the Chigira's healing criteria for simple bone cyst, grade Ⅰ , Ⅱ , Ⅲ,V were 1, 2, 10 and 7 cases respectively in steroid group, contrasting to 0, 3, 5 and 20 cases respectively in open resection and allograft group. The recovery rate was 85.0%(17/20) in steroid group and 89.3%(25/28) in open resection and allograft group, which was no statistically significant difference between two groups (P＞0.05). Conclusions Although the two remedies are no obvious difference in curative effect,simple bone cyst at lower extremity of weight-bearing with obvious osteolysis in adult is recommended to open resection and allograft, otherwise or at upper extremity to steroid injection.

BACKGROUND: Dendritic cells, the most potent antigen presenting cells known at present, have been extensively used in the immunotherapy as adjuvant. OBJECTIVE: The present study was to construct Der p 2 eukaryotic expression vector and validate its expression in the mouse bone marrow-derived dendritic cells. DESIGN, TIME AND SETTING: A single sample observation was performed at the Institute of Respiratory Disease,Xinqiao Hospital, Third Military Medical University of Chinese PLA between May and December 2005. MATERIALS: C57BL/6 mice were included. Plambd-Der p 2 was the product of Heska Company, USA.pCI-neo plasmid was provided by the Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University of Chinese PLA.METHODS: Mouse bone marrow-derived dendritic cells were in vitro isolated and cultured.Complete Der p 2 cDNA was spliced from prokaryotic expression vector plambd-Der p 2, and then cloned into eukaryotic expression vector pCI-neo (pCI-neo-Der p 2).The positive recombinants pCl-neo-Der p 2 transfected into dendritic cells.Non-transfected and blank vector pCI-neo-transfected dendritic cells were used as controls. MAIN OUTCOME MEASURES: ①Identification of pCI-neo-Der p 2 recombinant plasmid.②Detection of Der p 2 mRNA and protein expression by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot techniques. RESULTS: Sequencing results showed Der p 2 cDNA in pCI-neo-Der p 2 was in coincidence with the sequence registrated in Gene Bank.RT-PCR and Western Blot results showed that expression of Der p 2 mRNA and protein could be detectable in the pCI-neo-Der p 2-transfected dendritic cells. CONCLUSION: The Der p 2 cDNA was successfully constructed into the eukaryotic expression vector, and Der p 2 gene and protein could be expressed efficiently in dendritic cells.

BACKGROUND: The morbidity of diabetes mellitus increased recently.There are few reports about the pulmonary function status of the patients with diabetes mellitus.OBJECTIVE: To comparably observe the difference of the pulmonary function status between patients with diabetes mellitus and normal persons,and to probe into the relationship between the course of disease of diabetes mellitus and the functional change of pulmonary function.DESIGN: Case controlled observation SETTING: Renmin Hospital, Wuhan University PARTICIPANTS: Totally 90 patients with diabetes mellitus hospitalized in the Renmin Hospital, Wuhan University between January 2000 and De cember 2003 were recruited. All the patients participated in the experiment voluntarily. Totally 20 cases were of insulin dependent diabetes mellitns (IDDM) and 70 cases were of non-insulin dependent diabetes mellitus (NIDDM). Another 90 cases were divided into 2 groups with the boundary line of 10 years: group with disease course ＜10 years (n=40) and group with disease course ＞10 years (n=50). And 30 normal persons with healthy pulmonary function was set as healthy control group, all the testees were voluntary participants in the experiment.METHODS: Pulmonary function index of the participants of each group was measured: vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1%), peak expiratory flow rate(PEFR)maximal voluntary ventilation (MVV) and comparison was performed between them.Comparison of the pulmonary function status of the patients between different levels of diabetes mellitus.pulmonary function between different groups : Compared with health control group, VC , FVC and MVV of the patients with diabetes mellitus was significantly decreased (t=1.999-2.301, P ＜ 0.05).There was no significant difference in the VC, FVC and MVV between patients with monary function between patients with different diabetes mellitus: the pulmonary function status in the group with disease course ＞10 years was improved less than that in the group with disease course ＜10 years [ VC (L):2.62±0.65 vs 3.25±1.25;FVC(L): 2.40±0.52 vs 3.21±0.98;FEV1%:75.31±2.31 vs 80.63±5.56;PEFR (L/s):4.33±0.68 vs 5.98±1.02;MVV (L/s): 76.22±6.98 vs 89.21±5.69 (t=2.012-2.350, P ＜ 0.05)].CONCLUSION: Pulmonary function of the patients with diabetes mellitus has reduced tendency compared with the normal persons, and the pulmonary function of the patients with long course of disease decreases significantly. More attention should be paid to diabetes patients' pulmonary function changes.

Obiective To evaluate the efficacy of health package for the nurse in train evacuation, Methods The self-manufactured new mobile health package for the nurses provides shortcut and completed equipment in various basic nursing care, therapic procedure, condition observation, emergency aid and treatment for nursing staff who performed transportation in train evacuation.Results The potable health package can play an important role in several medical support training and have special mission. Conclusion The health package has mobile applicability and operability, which is an important equipment for successful medical support training.

Objective To analyze the effects of self-ligating bracket on enlarging the maxillary alveolar arch and to investigate the the non-extraction treatment programs.Methods All patients were used heat activated basic and precise theory for the orthodontist in order to make a plan fordeveloping nickel-titanium wire,then assessed by occlusalplane analysis method.The maxillary model andcephalometric radiographs were collected and measured before the treatment.The data of the resultswereanalyzed.Results After the treatment,the increase of the width of the dental arch was related to the /FMA,crowding degree and canines initial position.The increase of arch length was related to the ∠ANB,crowding degree,malocclusion classification,canines initial position andthe second molar eruption.Conclusion The essential factors include the crowding degree of arch,∠FMA,∠ANB,the angle of the anterior teeth,malocclusion classification,canines initial position andthe second molar eruptioncan affect the result of non-extraction quick self-ligating bracket appliance treatment on enlarging the maxillary alveolar.

Objective To detect the effect of osthole on proliferation and apoptosis of HL-60 cells and its molecular mechanism.Methods HL-60 cells proliferation was measured through the CCK8 assay method.The cell morphological changes were observed by Hoechst33342 staining after 8 h of drug effect.Induction of apoptosis was determined by flow cytometry and fluorescent microscopy.Expressions of Bcl-2 and Bax mRNA were evaluated by RT-PCR,and the expressions of cleaved caspase-3,caspase-8,caspase-9,Fas and FasL were evaluated by using western bolt assay.Results Osthole could inhibit the proliferation of HL-60 cells,the maximum inhibiting rate was (90.7 ±4.5)％,F =138.46,P =0.000; the apoptosis rate was 33.6％,F =27.75,P =0.006.The changes of apoptosis of cells and nucleus were shown in cell morphological observation.Osthole affected the decrease of the mRNA levels of Bcl-2 and the increase of the Bax mRNA levels via a dosedependent manner(F =210.12,P =0.000).Western blotting demonstrated that osthole could lead to the increase of the expression levels of cleaved caspase-3,caspase-8,caspase-9,Fas and FasL in the HL-60 cell line via a time-dependent manner.Conclusion Data suggests that osthole inhibits proliferation and induces apoptosis of HL-60 cells through mitochondria-dependent pathway and death-receptor pathway.

Adolescent ; Bacteria ; drug effects ; isolation & purification ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Urinary Tract Infections ; drug therapy ; microbiology