ObjectiveTo assess the degree of pain in elderly patients with mechanical ventilation in ICU using critical-care pain observation tool(CPOT) and to choose the correct sedative and analgesic method.Methods 110 elderly patients in ICU after neurosurgery were divided into three assessment stages,every stage had two record points and total six points (T1-T6):the first stage (intubation and unconsciousness,T1-T2),the second stage (intubation and consciousness,T3T4 ) and the third stage(extubation and consciousness,T5-T6 ).Among them T1,T3and T5were nonnocuity assessment points of every stage,while T2,T4 and T6 were nocuity assessment points of every stage.The assessment time was one minute at every point.After recorded at every point in second and third stages,patients were asked to use the pain intensity descriptive scale (PIDS) themselves.CPOT,heart rate and mean arterial pressure (MAP) from T1 to T6 were recorded as well as PIDS from T3 to T6 in second and third stages.Results In the three stages,CPOT〔(26.8 vs.0.54,3.36 vs.1.20,2.78 vs.0.68) scores〕,HR〔(95 vs.85,94 vs.82,94 vs.84)beat/min〕 and MAP〔(95 vs.85,95 vs.87,94 vs.87)mm Hg〕 at T2,T4and T6 were higher than T1 (t=-42.89,-55.95,-55.38),T3 (t =- 5.52,- 11.33,- 11.78) and T5 ( t =- 5.54,- 9.95,- 11.33 ) ( P＜ 0.05 ).The PIDS at T4 and T6were higher than at T3and T5in the second and third stages 〔(2.52 vs.1.69,2.12 vs.1.44)scores〕 (P＜0.05).The correlation coefficient between CPOT and PIDS at T3 and T4 in the second stage were 0.49 and 0.58,respectively (P＜0.05),and between CPOT and PIDS at T5 and T6 were 0.52 and 0.59 in the third stage,respectively (P ＜ 0.05),and they both reached moderate correlation.ConclusionsCPOT may be an effective way to assess the degree of pain in elderly patients with mechanical ventilation at present.

Objective To investigate clinical significance of proinsulin and true insulin in obese children with impaired glucose tolerance (IGT).Methods There were 21 IGT and 52 normal glucose tolerance (NGT) children. Control cases were 40 normal children. The levels of serum fasting proinsulin,true insulin,insulin,c-peptide and glucose were measured in all the subjects.Results 1.Levels of fasting proinsulin,c-peptide, glucose, insulin, true insulin and homeostasis insulin resistance in obese children with IGT showed significant difference compared with NGT (P

AIM: To isolate and culture endothelial progenitor cells (EPCs) in blood vessel by in vitro amplification from bone marrow of rabbits to provide cytology basis for the implantation of autologous EPCs in the repair of blood vessel endothelium. METHODS: The experiment was performed at the Department of Cardiology, Changzheng Hospital, Second Military Medical University of Chinese PLA from March 2005 to February 2006. ①Dil labeled acetylated low density lipoprotein, FITC labeled BS-1 lectin, mouse anti-human CD34 antibody, rabbit anti-human FIK-1 antibody, mouse anti-human CD133 monoclonal antibody were purchased from molecular probes company, vector company, Biolegend company, Biolegeng company and R&D company. ②Totally 8 New Zealand rabbits were selected to extract the bone barrow. Mononuclear cell was isolated from bone marrow by density centrifugation. With the inoculated density of 1?106/cm2, it was put in the M199 medium containing vascular endothelial growth factor and Basic fibroblast growth factor (bFGF) for in vitro cultivation for 7 days. Cell growth and reproductive activity were observed. ③EPCs were identified by Dil labeled acetylated low density lipoprotein and FITC labeled BS-1 lectin. The cells showed red fluorescence were cells phagocytized acetylated low density lipoprotein, while those with green gluorescence were cells bind with BS-1, and the cells double stained showed orange fluorescence. ④Expressions of CD133, CD34 and Flk-1 were detected with immunofluorescent staining and flow cytometry. RESULTS: ①Observation of cell morphous: New isolated mononuclear cells were round. After cultivation for 72 hours, adherent cells showed colony-like growth, and the cells were round or irregular, and the caryocinesis was relatively obvious. Till the 7th day after cultivation, cell colony was connected each other, showing fusiform endothelioid cells. ②Reproductive activity of EPCs in blood vessel: At days 2-4, the reproduction of EPCs was rapid, and then became slow gradually. Growth curve showed typical "S" shape. At days 6 and 7, the EPCs grew rapidly. The absorbance (A) reached 0.58?0.15 and 0.62?0.23, respectively. ③Result of EPCs identification by Dil labeled acetylated low density lipoprotein and FITC labeled BS-1 lectin: In kytoplasm of EPCs, red fluorescent concentration bind with acetylated low density lipoprotein appeared, with the positive rate of over 95%. Combined rate with BS-1 lectin reached 100% nearly. Double staining rate reached over 90%. ④Result of EPCs immunohistochemical method and flow cytometry: The cell-surface marker CD133, FlK-1 and CD34 were positive. CONCLUSION: Cell colony with the feature of EPCs can be isolated and cultured from rabbit bone marrow by in vitro amplification method successfully.

AIM: To evaluate the effects of glycemic control on refraction in diabetic patients. METHODS: Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose, HbA1c levels, fasting C-peptide and postprandial 2h C-peptide were measured before treatment. The patients with random blood glucose higher than 12.0mmol/L and HbA1c level higher than 10.0% were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1, 2, 3 and 4 during glycemic control.RESULTS: A transient hyperopic change occurred in all the patients receiving glycemic control. The maximum hyperopic change was 1.60D (range 0.50±3.20D). Recovery of the previous refraction occurred between two and four weeks after insulin treatment. There was a positive correlation between the maximum hyperopic changes and the HbA1c levels on admission (r=0.84, P<0.05). There was a positive correlation between the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment (r=0.53, P<0.05). During transient hyperopia, no significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length.CONCLUSION: Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of the blood glucose level.

Objective:To assess the effect of auto-bone marrow mononuclear cells (BMMNCs) transplantation on reendothelialization and neointima formation in vein grafts. Methods: BMMNCs were extracted from the bone marrows of adult rabbit under sterile environment and were labelled with DAPI before transplanted into vein grafts. Twenty adult rabbits were randomly divided into 2 groups: BMMNCs transplantation group(groupⅠ,n=10) and PBS transplantation group (group Ⅱ, n=10). The left external jugular vein of 20 rabbits were harvested and transplanted between ipsolateral common carotid artery(AVG). Three days later, animals in group Ⅰ were transplanted with BMMNCs(6?108 cells)/100 ?l via periotic veins and those in groupⅡwere injected with 100 ?l PBS. Animals were killed 4 weeks later and graft veins were harvested to observe the reendothelialization and the thickness of vein grafts. Results: We found that the transplanted cells survived and were incorporated into the endothelium of vein grafts in groupⅠ.The endothelium integrity of the vein grafts in groupⅠwas significantly better than that of groupⅡ. The intima thickness of vein grafts in groupⅠwas significantly thicker than that of groupⅡ. Conclusion: BMMCs transplantation therapy may improve reendothelialization of the vein graft and inhibits intimal hyperplasi the vein graft.

Background Vascular endothelial growth factor(VEGF) has been shown to be associated with the pathogenesis of age-related macular degeneration (AMD),therefore VEGF is a target for the treatment of wet AMD.However,the mechanism of VEGF in the pathogenesis of AMD is not clearly understood.Studying the correlation between VEGF gene polymorphism and AMD is becoming a new research hotspot,but relevant studies on Han Chinese have not been performed.Objective This study was to investigate the association between the VEGF +936C/T gene polymorphism and AMD in the Chinese population.Methods A pilot prospective and nonrandomized controlled trial was designed.This protocol complied with Declaration of Helsinki and was approved by the Ethic Committee of Chinese PLA Second Artillery General Hospital.Written informed consent was obtained from each subject prior to entering the study.Two hundred AMD patients and 200 age-and gender-matched normal controls were enrolled in this study.The genomic DNA was extracted from the peripheral blood samples of the subjects,and analysis of the VEGF polymorphisms at the +936 position in the promoter and 3＇-untranslated regions was performed by the restriction fragment length polymorphism method.Frequencies of the VEGF+936C/T genotype were compared between the two groups,and the risk of the VEGF+936C/T gene polymorphism in pre-disposing AMD was evaluated.Results No significant differences were seen in the incidence rates of smoking(P ＝ 0.76),hypertension(P ＝ 0.84),hyperlipidemia (P=0.71),diabetes mellitus (P=0.86) and cardiovascular disease(P=0.89) between the AMD group and the normal control group,and BMI was matched between the two groups (P =0.18).The prevalence of the TT genotype was 9.0％ (18/200)in the AMD group,but that in the normal control was 3.5％ (7/200),showing a significant difference between the two groups (P =0.03).The odds ratio (OR) was 2.73 with a 95％ confidence interval(CI) of 1.11 to 6.68 for AMD in this genotype.The CC and CT genotypes were not significantly different between the two groups (P =0.52,P =0.57).The genotype frequency and allele frequency conformed to HardyWeinberg equilibrium law.There were no significant differences found in the CC,CT,TT genotype frequencies among the early AMD,geographic atrophy AMD and choroidal neovascular AMD (all at P＞0.05).Conclusions The VEGF+936TT genotype is associated with AMD in Han Chinese population.

Both sides of the picornavirus genome have 5'-untranslated region (5'UTR) and 3'- untranslated region (3'UTR). This study demontrated that both the 5'-and 3'-UTR can form complex structures, such as stem-loop, clover and pseudoknot structure, These structures play an important role in the regulaton of the replication and translation of the viruses. This article reviewed the progress of research on the structure and function of picornavirus' 3'-UTR over recent years.
3' Untranslated Regions ; Animals ; Humans ; Nucleic Acid Conformation ; Picornaviridae ; chemistry ; genetics ; metabolism ; Picornaviridae Infections ; virology ; RNA, Viral ; chemistry ; genetics ; metabolism

Objective To evaluate the conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in diagnosis of splenic trauma including its grading diagnosis. Methods US and CEUS in 42 patients with splenic trauma confirmed by CT and/or operation were performed during 9.2004-10.2007. All the data were compared and analyzed retrospectively. Results Of 42 patients with splenic trauma, 28 cases were detected and 14 cases were missed on US examination, whereas, 40 cases were detected and only 2 mild cases were missed on CEUS examination. The detection rate of lesions with CEUS was significantly higher than that of US (P<0.001) . Ten cases in grading the injury were underestimated by US, however, none of them were underestimated by CEUS. CEUS had good concordance with CT and/or operation in grading diagnosis of 42 cases except two mild cases. Conclusions CEUS has very good concordance with CT and/or operation in detecting injury and grading the splenic trauma compared with conventional US. CEUS as a new imaging technology has made great advance of ultrasoongraphy in evaluation of splenic trauma including injury grading,and it is very useful in clinical application.

· AIM: To inspect and compare the functional vision of an aspheric intraocular lens (Tecnis) with those of conventional monofocal silicone and acrylic intraocular lens and multifocal intraocular lens (Array).· METHODS: The IOLs were tested in the eye model, which was designed to be optically equivalent to the theoretical eye model. The eye model is a combination of a spherical photographic lens with 35mm focal length ( IOL put in a water cell)and a charge coupled device (CCD) camera. The images constructed by the lenses are observed on a monitor of personal computer and the contrasts of the images are analyzed by using commercial image processing software.· RESULTS: The modulation transfer function of the eye model equals the scale produced by the theoretical eye model. The images constructed by changing the diameter of aperture stop and IOL.· CONCLUSION: The proposed eye model is useful for testing functional vision and for inspecting differences of intraocular lens.

Objective To explore the changes of CD40 and CD40 ligand(CD40L) levels and investigate their significances in children with graft-versus-host disease(GVHD)after related-donor human leukocyte antigen(HLA) matching allogeneic hematopoietic stem cell transplantation(HSCT).Methods Nineteen patients with ?-thalassemia major and 1 patient with congenital inherent hemolytic anemia accepted umbilical cord blood transplantation(UCBT) and allogeneic peripheral blood stem cell transplantation(allo-PBSCT),respectively,and all cases were received successfully related-donor human leukocyte antigen matching allogeneic HSCT.Peripheral blood samples were obtained before and after transplantation,the time when GVHD happened,the expressions of CD40 and CD40L were measured by using immunofluresence asssy.Results Four UCBT children and 3 allo-PBSCT children had no acute GVHD.Thirteen children had acute GVHD(degreeⅠ-Ⅳ),the expressions of CD40L on CD4+ and CD8+ T cells in the patients with acute GVHD increased,especially in allo-PBSCT.Five cases of UCBT and 12 cases of allo-PBSCT patients had chronic GVHD,the expressions of CD40L+,CD25+ and CD69+ on CD4+ and CD8+ T cells in patients with chronic GVHD increased obviously.The expression of CD19+CD40+ was lower than normal within 3 months after transplantation.Conclusions The high expression of CD40L+T cells in periferal blood after HSCT was related to the activation and proliferation of T cells in the development of GVHD in HSCT.