Objective To study the value of plasma D-dimer ＜ 500 μg/L level in diagnosis of pulmonary thromboembolism occurred in patients.Methods The clinical data of the patients with pulmonary embolism confirmed by imaging examination with plasma D-dimer levels ＜ 500 μg/L admitted from January 1st 2008 to June 30th 2011 were analyzed retrospectively.Results Totally,there were ten pulmonary embolism patients with plasma D-dimer levels ＜ 500 μg/L.The 10 eligible patients were assessed for the possibility of pulmonary embolism by using the Wells score (i.e.Wells clinical pretest probability prediction model).Of them,0 cases was evaluated as low clinical pretest probability (grade ＜2),7 cases as moderate clinical pretest probability (grade 2 ～6) and 3 cases as high clinical pretest probability (grade ＞ 6).Conclusions Pulmonary thromboembolism was easily misdiagnosed for lacking specific clinical manifestations and the missed diagnosis in patients caused high mortality,so it was difficult to exclude acute pulmonary embolism simply depending on the D-dimer levels ＜ 500 μg/L.Therefore,in case of plasma D-dimer levels less than 500 μ g/L,the possibility of pulmonary embolism cannot be ruled out in patients with moderate or high Wells clinical pretest probability.

Objective:To develop a simple culture and purifying method for rat dental follicle cells.Methods:The upper and lower first and second intact molar germs of SD rat were separated. Then, dental follicle and enamel organ were stripped together, minced into little pieces, digested with collagenase and cultured. Dental follicular cells were purified by differential passage and indentified by immunohistochemical staining of vimentin and cytokeratin. Results:The primary cells were mixed, consisting of dental follicle cells and enamel organ cells. After differential passage, the cells of fourth passage became purified dental follicle cells. Purified dental follicle cells were elongated spindle or triangle in shape, positive for vimentin and negative for cytokeratin.Conclusion:Dental follicle cells can be purified by several differential passages from the mixed primarily cultured cells.

Objective To evaluate the efficacy of servo controlled sevoflurane closed-circuit anesthesia and the feasibility of the predictive and intelligent control.Methods One hundred and forty-three ASA Ⅰ-Ⅲ patients (90 males, 53 females) aged between 3-77 yrs undergoing elective surgery were studied. Anesthesia was induced with intravenous fentanyl 2-3 ?g ?kg-1 , midazolam 0.12 mg?kg-1 and vecuronium 0.1 mg?kg-1 . After tracheal intubation the tracheal tube was connected to the servo-controlled closed-circuit system composed of IBM computer, O2 mass flow controller and electrically controlled sevoflurane injection pump and multifunctional monitor. The fresh gas flow of O2 = [body weight (kg)3/4 ? 10 + 20] ml?min-1 . The end-expired sevoflurane concentration was maintained at 1.3 MAC by predictive and intelligent control.Results The average wash-in time to reach the target concentration was (5.2 ?2.4) min. The O2 flow rate was(0.22?0.04) L?min-1 . The cumulative uptake of sevoflurane was 5.16 ml, 7.74ml, 9.17ml, 11.08ml, 12.57ml, 13.00ml, 14.18ml, 15.60ml, 18.56ml and 24.6 ml at 30, 60, 90, 120, 150, 180, 210, 240, 300 and 420 min respectively. The uptake rate of fluid sevoflurane was equivalent to (0.2673e-0.0598t + 0.2269e-0.0597t + 0.1150e-0.002t) ml?min-1 . Conclusion The servo controlled sevoflurane closed-circuit system can effectively control the pre-set end-tidal sevoflurane concentration in spite of the influence of multiple factors and is safe and effective.

Animals ; Animals, Newborn ; Cells, Cultured ; Fibroblasts ; cytology ; metabolism ; Matrix Metalloproteinase 1 ; metabolism ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Myocardium ; cytology ; metabolism ; Oligopeptides ; physiology ; Rats ; Rats, Wistar ; Transforming Growth Factor beta ; pharmacology

Objective To investigate the expressions and significance of transforming growth factor-beta 1(TGF?1) and its typeⅡ receptor(TGF?RⅡ) in experimental rat ascending aortic aneurysm of rat model.Methods The rat ascending aortic aneurysm models were made by banding ascending aorta of young Wistar rats.The ascending aortas were taken 4 months after operation.Immunohistochemistry staining and Western blotting were used to investigate the expressions of TGF?1 and TGF?RⅡ.Result Immunohistochemistry staining results showed that TGF?1 expressed in all layers of the aortic aneurysm and the control.TGF?RⅡ was extensively located in the hyperplastic intima and tunica media smooth muscle cells in the aortic aneurysm,while there was only a little positive staining in the control group.Western blotting results indicated that the expression levels of TGF?1 and TGF?RⅡ in the aortic aneurysm were stronger than the control,P

BACKGROUND: Sleep deprivation cannot only cause learning and memory impairment of animal and human, but also lead to increased content of nitric oxide in brain tissue of rats. Melatonin has the effects of antifreeradical and antioxidation. It has been reported that melatonin can improve aluminum chloride and morphine abstinence induced learning and memory impairment of animal, however, whether it has influence on sleep deprivation induced learning and memory impairment is not very clear. OBJECTIVE: To observe the effect of melatonin on memory of rats after sleep deprivation and analyze its possible mechanism. DESIGN: Randomized controlled trial.SETTING: Teaching and Experiment Center of Basic Medicine and Department of Nursing, the Fourth Military Medical University.MATERIALS: The experiment was performed in Teaching and Experiment Center of Basic Medicine of the Fourth Military Medical University in January 2005. A total of 24 adult male Sprague Dawley rats were selected and randomly divided into 3 groups, namely, control group, small dosage of melatonin group and large dosage of melatonin group, with 8 in each group on the basis of random digits table.METHODS: To rats in small dosage of melatonin group and large dosage of melatonin group, the dosage of melatonin was 5 mg/kg and 15 mg/kg respectively, which was made into 2 mL solution and intraperitoneally injected into the rats at 17:00 o'clock every day, while rats in control group were injected with 2 mL physiological sodium at the same time, once a day for continuous 7 days. Then a 3-day sleep deprivation was given to the rats; melatonin or physiological sodium were also given according to different groups during these days. Rat model of sleep deprivation was established by "Flower Ppot" technique; water maze was used for detecting the memory of rats after 48-hour and 72-hour sleep deprivation; took escape latency (s) as indicator of changes of learning and memory of rats; the shorter the escape latency, the better the spacial memory of rats. When sleep deprivation was finished, all the rats were put to death and hippocampus and cerebral cortex were taken out in ice bath. The content of nitric oxide in cerebral cortex and hippocampus was detected with the method of nitrate reduction, and malondialdehyde (MDA) with the method of thiobarbital acid.MAIN OUTCOME MEASURES: Results of escape latency after 48hour and 72-hour sleep deprivation. Contents of nitric oxide and MDA in cerebral cortex and hippocampus of rats.There was significant difference in escape latency in water maze after 48-hour and 72-hour sleep deprivation among each group (F=11.886, P=0.000)and (F=5.440, P=0.012); the escape latency after 48-hour and 72-hour sleep deprivation remarkably decreased both in small and large dosage of melatonin groups as compared with control group, and the latency after 48-hour sleep deprivation was shorter in large dosage group than that in small ide and MDA in brain of rats among each group, namely, nitric oxide in cerebral cortex (F=14.038, P=0.000), MDA in cerebral cortex (F=27.414,P=0.000), nitric oxide in hippocampus (F=22.692, P=0.000), MDA in hippocampus (F=14.316, P=0.000). Compared with control group, the contents of nitric oxide and MDA in cerebral cortex and hippocampus in the two experimental groups decreased significantly, and there was obvious difference in the content of nitric oxide in hippocampus between large and small dosage groups, which showed a dose-effect relationship.CONCLUSION: Melatonin can improve memory impairment of rats after sleep deprivation, which may be closely related to the effect of inhibiting the increase of nitric oxide and MDA in their cerebral cortex and hippocampus.

Objective To design a checklist (NICU-PoHC) for postoperative handover in the NICU (Neurosurgery Intensive Care Unit) in case of information omissions or task errors during the handover process,thus to improve patient safety.Methods Team discussion and literature review was conducted to compose the preliminary version of the NICU-PoHC.Then two rounds of panel review were conducted using the Delphi methods to revise the preliminary checklist and to calculate its Content Validity Index (CVI).Results The authority coefficient of experts was 0.86.Twenty experts proposed 7 suggestions for revision.The NICU-PoHC was developed,and its CVI was 0.88.Conclusions Our study developed the NICU-PoHC,which can be used as an assistant tool guiding the postoperative handover,preventing information omissions and task errors,and thus improving patient safety.

For a long time, limited by the factors such as laparoscopic technology, and limited medical resources , the residents accepting standardized training are lack of mastery of the technology . Meanwhile, it is the key to the training of personnel training and reserve in the field for residents to contact the laparoscope as soon as possible and carry out scientific and effective training. Therefore, based on the traditional method, we have developed a new type of laparoscopic teaching system for the standardized training residents and increased and integrated the LAP GAME R operations training system and the real-time multimedia teaching platform. The preliminary practice effect is good.

OBJECTIVE:To study the stability of Tramadol hydrochloride,Fentanyl citrate and Ondansetron hydrochloride in-jection in 0.9% Sodium chloride injection. METHODS:At room temperature [(25±1)℃],three injections were poured into infu-sion bag of disposable analgesia pump,and diluted with 0.9% Sodium chloride injection. The changes in precipitation,turbidity, color and pH value of the mixture were observed. The relative percentage of three injections within 72 h were determined by HPLC method. RESULTS:There was no significant change in the pH value and appearance of the mixture. Relative percentage of tramad-ol hydrochloride,fentanyl citrate and ondansetron hydrochloride were all higher than 97% within 72 h. CONCLUSIONS:The mix-ture of Tramadol hydrochloride,Fentanyl citrate and Ondansetron hydrochloride injection in 0.9% Sodium chloride injection keep stable within 72 h under room temperature.