Objective To observe the long-term effect of combined intestine/auxiliary liver transplantation in rat.Methods Male Lewis rats were used. Total small bowel and 60 % liver were transplanted en bloc with an aortic segment that contained the celiac axis and superior mesenteric artery ensuring the blood supply to the graft. The end-to-side anastomosis was made between donor infrahepatic vena cava (IHVC) and recipient IHVC. The recipient small bowel was resected and the intestine continuity was restored. Sham control (laporotomy only) and transplantation groups were included. Ten rats in each group were followed-up for 18 months and then sacrificed. Liver function tests, terminal deoxynuleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate (dUTP) nick end labeling (TUNEL) staining and proliferating cell nuclear antigen (PCNA) staining of liver tissue were evaluated.Results Sixteen rats survived over the operation. There were no significant differences in liver function tests between the sham control group and transplantation group. The grafted liver was hypertrophic and native liver did not regenerate 18 months following transplantation with an increased liver/body weight ratio. TUNEL-staining showed no significant differences among grafted liver, native liver of the recipient rat in transplantation group and the liver of the rat in control group. PCNA-staining revealed that the native liver in transplantation group had a lower proportion of TUNEL-positive hepatocytes. Conclusion This experimental study confirmed the long-term consequences of combined intestine-auxiliary liver transplantation, and the results suggest that liver/body weight ratio can be increased.

Objective:To survey the enablement level of elderly patients in the community and its influencing factors.Methods:A total of 460 patients aged ≥60 years visiting Changfeng and Fenglin Community Health Service Centers of Shanghai during September 3 to 15, 2018 were invited for a questionnaire survey. A self-made health status questionnaire, Patient Enablement Instrument (PEI), Chinese Health Questionnaire (CHQ-12), the Consultation and Relational Empathy Measure (CARE) were applied for survey.Results:All valid 460 questionnaires were retrieved. The positive rate of patient enablement was 73.91% (340/460). The median score for PEI was 3, Q1 was 0 and Q3 was 6. The univariate analysis showed that patient′s gender( Z=-2.32, P=0.02), age ( H=9.73, P<0.01), reason for visit ( H=42.06, P<0.01), health status in the past year ( H=8.28, P=0.02), consultation time ( H=22.92, P<0.01), sufficiency of communication with the doctor as patient thought ( H=41.83, P<0.01), detailed inquisition ( H=81.11, P<0.01), attending a contracted doctor ( Z=-3.42, P=0.04), the satisfaction of the visit ( H=38.64, P<0.01), total score of CHQ-12 ( Z=-2.01, P=0.04) and the score of CARE were significantly associated with the enablement level of the patient after the visit ( H=288.06, P<0.01). Multivariate linear regression showed that age 60-79( P=0.03), visit for acute disease( P<0.01), good or moderate health status in past year ( P<0.01), communication with the doctor<3 min or 3-<5 min ( P<0.01), sufficient or moderate time for communication with the doctor as patient thought ( P<0.01), detailed or moderate inquisition( P=0.03 or P=0.01), attending a contracted doctor ( P<0.01), CHQ-12 ≥4 ( P<0.01), middle or high CARE score ( P<0.01)were associated with the enablement of elderly patients after visit, with a cumulative contribution rate of 73.40%( F=50.08, P<0.01). Conclusion:The level of enablement of elderly patients after visiting the general outpatient clinic of the community health service center is relatively low. Patient′s age, types of disease, health status and the time of communication with the doctor, the sufficiency of communication time as patient thought, the detailed inquisition, attending a contracted doctor, the mental health status, and the empathy expression of the doctor are associated with the enablement of patients.

BACKGROUND: The survival rate of patients after cardiac arrest (CA) remains lower since 2010 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) was published. In clinical trials, the methods and techniques for CPR have been overly described. This article gives an overview of the progress in methods and techniques for CPR in the past years. DATA SOURCES: Original articles about cardiac arrest and CPR from MEDLINE (PubMed) and relevant journals were searched, and most of them were clinical randomized controlled trials (RCTs). RESULTS: Forty-two articles on methods and techniques of CPR were reviewed, including chest compression and conventional CPR, chest compression depth and speed, defibrillation strategies and priority, mechanical and manual chest compression, advanced airway management, impedance threshold device (ITD) and active compression-decompression (ACD) CPR, epinephrine use, and therapeutic hypothermia. The results of studies and related issues described in the international guidelines had been testified. CONCLUSIONS: Although large multicenter studies on CPR are still difficult to carry out, progress has been made in the past 4 years in the methods and techniques of CPR. The results of this review provide evidences for updating the 2015 international guidelines.

OBJECTIVE:To observe clinical efficacy and ADR of Houttuynia cordata eye drops combined with Olopatadine eye drops in the treatment of allergic conjunctivitis. METHODS:160 eyes with allergic conjunctivitis were randomly divided into observation group and control group,with 80 eyes in each group. The control group was given olopatadine eye drops,and observa-tion group was additionally given H. cordata eye drops(medication interval>10 min)on the basis of control group. Both groups were treated for 14 days. Symptoms and signs of 2 groups were observed and scored before treatment and 14 d after treatment. Ef-fective rates of 2 groups were calculated,and the occurrance of ADR was observed. RESULTS:Compared with before treatment, symptoms and sings score of 2 groups were decreased,with statistical significance (P<0.01 or P<0.05);the decrease of two score in observation group were more significant than in control group,with statistical significance (P<0.05);effective rates of control group and observation group were 37.50%and 77.50%,with statistical significance(P<0.05). CONCLUSIONS:H. corda-ta eye drops combined with olopatadine eye drops can ameliorate clinical symptoms and signs of allergic conjunctivitis patients sig-nificantly,and improve therapeutic efficacies without obvious ADR.

The impeller profile, which is one of the most important factors, determines the creation of shear stress which leads to blood hemolysis in the internal flow of centrifugal blood pump. The investigation of the internal flow field in centrifugal blood pump and the estimation of the hemolysis within different impeller profiles will provide information to improve the performance of centrifugal blood pump. The SST kappa-omega with low Reynolds correction was used in our laboratory to study the internal flow fields for four kinds of impellers of centrifugal blood pump. The flow fields included distributions of pressure field, velocity field and shear stress field. In addition, a fast numerical hemolysis approximation was adopted to calculate the normalized index of hemolysis (NIH). The results indicated that the pressure field distribution in all kinds of blood pump were reasonable, but for the log spiral impeller pump, the vortex and backflow were much lower than those of the other pumps, and the high shear stress zone was just about 0.004%, and the NIH was 0.0089.
Assisted Circulation ; Heart-Assist Devices ; Hemolysis ; Humans ; Models, Theoretical ; Stress, Mechanical

Objective To observe any effect of transcutaneous electrical nerve stimulation (TENS) on pul monary function,airflow obstruction,dyspnea,exercise capacity and levels of tumor necrosis factor-α (TNF-α) in the sputum of patients with chronic obstructive pulmonary disease (COPD).Methods Thirty patients with stage Ⅰ or Ⅱ COPD were randomly divided into a treatment group and a control group with 15 cases in each.TENS applied at the Feishu acupuncture point (BL13) was used in the treatment group,while sham stimulation of the same point without current output was used in the control group.The treatment was administered 40 minutes once daily,5 days a week for a total of 4 weeks.The outcome measures were measured before and after 4 weeks of treatment.Results FVC,FEV1,FEV1％,and peak expiratory flow rate (PEFR) all improved significantly in the treatment group after 4 weeks of treatment.After treatment,the average TNF-α level in induced sputum and exercise capacity as indicated by the average BODE index had both improved significantly in the treatment group.Compared with the control group,pulmonary function,TNF-α and the BODE index in the treatment group were all significantly better.There was no significant difference in pulmonary function,BODE index or TNF-α before and after treatment in the control group.Conclusion TENS at the Feishu acupoint can reduce airway inflammation,improve pulmonary function and exercise capacity,and decrease TNF-α levels in patients with stage Ⅰ or Ⅱ COPD.This treatment should be very useful for enhancing their ability in the activities of daily living.

BACKGROUND: The metal implant internal fixation exhibits good effect for femoral neck fractures of young patients, but few studies report the metal implant treatment for femoral neck fracture in the aged patients. OBJECTIVE: To compare different implant treatments for osteoporotic hip fractures in senile patients. METHODS: A total of 237 aged patients with osteoporotic hip fracture, aged from 60 to 96 years old, were recruited from the hospital between January 1998 and December 2008. There were 32 cases treated by cannulated screw internal fixation, 23 cases by anatomical plate internal fixation, 41 cases by dynamic hip screw internal fixation, 111 cases by bipolar femoral head replacement, and 30 cases by total hip replacement. Comparison of the incidence of complications and the recovery of hip function were performed in each group. RESULTS AND CONCLUSION: Cannulated screws, anatomical plates, dynamic hip screw internal fixation showed a higher complication rate significantly than bipolar femoral head replacement and total hip arthroplasty (P < 0.01); the good and excellent effect rate in cannulated screw, femoral end plate, and dynamic hip screw fixation was significantly lower than that in bipolar femoral head replacement and total hip arthroplasty (P < 0.001, P < 0.01). The results suggested that artificial joint replacement (bipolar femoral head replacement or total hip replacement) is the optimal choice for aged osteoporotic femoral neck fracture, cannulated screw fixation is suitable for Garden I, dynamic hip screw fixation and proximal femoral anatomical plate fixation fit for intertrochanteric fractures of Jensen-Evans I-Ⅱ; Jensen-Evans Ⅱ-Ⅲ osteoporotic intertrochanteric fractures joint replacement is the ideal choice.

Background and purpose. Chemotherapy is a standard treatment for patients with advanced stage non-small cell lung cancer (NSCLC) However, platinum based chemotherapeutic regimen haves high toxicity profile to normal tissues. Lobaplatin (LBP) is a new third-generation antitumour platinum drug. Studies abroad have shown that Iobaplatin has an anticancer activity similar to cisplatin with better tolerance and is more effective for those who are resistant to cisplatin. This study was aimed to observe the effectiveness and toxicities of lobaplatin combined with vinorelbine (NVB) for the treatment of advanced NSCLC. Methods: Sixty-four patients pathologically diagnosed as clinical stage Ⅲ_B-Ⅳ NSCLC who did not receive treatment before, were randomly assigned to two groups. NL group (NVB+LBP): LBP at a dose of 30 mg/m~2 intravenous infusion on day 1, and NVB at a dose of 25 mg/m~2 intravenous infusion on days 1 and 8. NP group (NVB+DDP): Cisplatin (DDP) at a dose of 30 mg/m~2 intravenous infusion on day 1, 2 and 3 and NVB at a dose of 25 mg/m~2 intravenous infusion on days 1 and 8. Treatments were repeated every 21-28 days for 3 cycles. Results: For 34 patients of NL group, there were CR (1 cases), PR(13 cases), NC(15 cases), and PD(5 cases). The overall response rate (RR) was 41.2%, disease control rate (DCR) was 85.3%. In NP group: RR was 43.3%, DCR was 83.3% (X~2=0.05, P>0.05). Median overall survival time was 8.6 months and 8.9 months for NL group and NP group, respectively. The main toxicities in NL group were myelosuppression. Digestive toxicity such as anorexia, nausea,vomiting were less than those in the NP group (X~2=7.43, P<0.05), Peripheral hour,toxicity, serious liver and renal toxicity were not observed in NL group. Conclusion: Compared with cisplatin plus vinorelbine, domestic lobaplatin with vinorelbine yielded similar efficacies for NSCLC, but had less toxicity and well tolerate.

OBJECTIVE:To optimize the formulation of indomethacin-loading solid lipid nanoparticle(SLN). METHODS:Us-ing indomethacin as model drug,glyceryl behenate as oil phase,poloxamer 188 and polyethylene glycol-12-hydroxystearic acid as emulsifier,with turbidity,entrapment efficiency and drug loading amount as index,Box-Behnken response surface methodology was used to optimize the amount of oil phase,emulsifier-oil phase ratio,drug-oil phase ratio. The physicochemical properties of SLNs were characterized by SEM and DSC. RESULTS:The optimal formulation was as follows as oil phase of 0.91%,emulsifier-oil ratio of 1∶1,drug-oil phase ratio of 1∶5. The turbidity,entrapment efficiency and drug loading amount of prepared nanoparticle were 1 025-1 030 NTU,98.94%-99.08%,2.43%-2.46%,respectively;particle size and polydispersity index(PDI)were 181.5-182.3 nm and 0.340-0.341(n=3). The results of DSC showed that indomethacin was not present in crystalline state dispersed into SLNs. CONCLUSIONS:The optimal formulation is screened successfully,and indomethacin-loaded SLNs have been prepared.

Objective To observe the effect of electroacupuncture and nerve and tendon gliding exercises on mild to moderate carpal tunnel syndrome.Methods Forty patients with mild to moderate carpal tunnel syndrome were randomly divided into an observation group and a control group,each of 20.Both groups were given neurotrophic drugs.The observation group was additionally provided with electroacupuncture and nerve and tendon gliding exercises,while the control group was given routine health education for 4 weeks.The Boston carpal tunnel syndrome questionnaire (BCTQ),a visual analogue scale (VAS),thumb and middle finger to wrist motor conduction velocity (MCV),sensory nerve action potentials (SNAPs),median nerve distal motor latency (DML) and the amplitude of compound muscle action potential (CMAP) of the musculi abductor pollicis brevis were evaluated.Results There were no significant differences in any of the measurements between the two groups before the treatment.After four weeks of treatment,significantly better improvement was observed in the average SCV of the thumb and wrist,the SCV of the digitus medius and wrist,the SNAP of the thumb and wrist,the SNAP of the digitus medius and wrist,the DML of the nervus medianus and the CMAP of the abductor pollicis brevis in the observation group compared to before the treatment and compared to the control group.Moreover,there was a significant decrease in the observation group's average BCTQ symptom score and function score and in their VAS ratings.However,in the control group significant differences were only found in the average SCV of the thumb and wrist,the DML of the nervus medianus and in their VAS ratings.Conclusions Electroacupuncture and nerve and tendon gliding exercises can significantly relieve symptoms and restore hand function.They are worth applying in clinical practice.