Objective To compare shikani optical stylet and Mc coy laryngoscope on elder patients with intratracheal intubation anesthesia.Methods 112 cases of elder patients with intratracheal intubation anesthesia were enrolled as study objects, all patients were divided into shikani optical stylet group (52 cases), Mc coy laryngoscope group (60 cases) according to different intubation way. Then detect the hemodynamic parameters, stress-related indicators, EEG relevant indicators of the two groups.Results One time success rate and total success rate in Shikani visual laryngoscope group was higher than Mc Coy visual laryngoscope group, while many times intubation rate was lower (P < 0.05); T1, T2 MAP, HR levels were lower in Shikani optical stylet group than Mc Coy laryngoscope group patients (P < 0.05); Plasma levels of epinephrine, norepinephrine, and glucose on T1, T2 in Shikani optical stylet group was lower than that in Mc Coy laryngoscope group (P < 0.05); T1, T2 BIS, ECoG grading, αβ% values in Shikani optical stylet group was lower than that in Mc coy laryngoscope group (P < 0.05).Conclusions Elderly patients with intratracheal intubation anesthesia received shikani optical stylet can enhance the success rate of intubation and effectively stabilize patients circulatory system, reduce excessive physical stress caused by various system dysfunction, which shows positive significance.

ObjectiveTo investigate the effects and mechanism of rosuvastatin on the expression of tissue factor in cultured human monocyte-macrophages cells which was induced by oxidized low density lipoprotein(ox-LDL).MethodsThe human monocyte-macrophages cells were divided into four groups:control group,ox-LDL group,Poly-inosine monophosphate (Poly Ⅰ) group,rosuvastatin group.The expression of LOX-1mRNA and TF mRNA was assayed by RT-PCR.The ELISA was performed to determine the protein concentration of TF.ResultsCompared with control group,the expression of LOX-1 mRNA and TF mRNA was increased in the ox-LDL group[ (3.25156±0.15772) vs (1±0) ; (2.522451±0.138967) vs (1±0) ],and it was in a concentration-dependent manner (P＜0.01).Compared with the expression of LOX-1 mRNA in the Poly-inosine monophosphate group and rosuvastatin group,TF mRNA were decreased in the ox-LDL group[ (2.95139±0.157253) vs(3.25156±0.15772) ; (2.877343±0.156558) vs(3.25156±0.15772) ; (1.811956±0.169699) vs (2.522451±0.138967) ; (1.687701±0.174647) vs (2.522451±0.138967)],and it was in a concentration-dependent manner(P＜0.05).Compared with control group,the expression of TF in the ox-LDL group was increased [(207.7233±1.154701) vs (184.8467±0.871799) ],and it was in a concentration-dependent manner (P＜0.01).Compared with the Poly-inosine monophosphate group and rosuvastatin group [(197.8733±1.505003) vs (207.7233±1.154701) ;(202.9567±2.722744)vs(207.7233±1.154701) ],the expression of TF in the ox-LDL group were decreased,and it was in a concentration-dependent manner (P＜0.05).ConclusionsLOX-1 may be responsible for the expression of TF in human monocyte-macrophages cells induced by ox-LDL.Rosuvastatin is able to down-regulate the expression of LOX-1mRNA in human monocyte-macrophages cells through oxLDL,and TF mRNA and TF expression can be reduced.

Objective To investigate the curative effect between liver resection combined with microwave ablation during operation and simple liver resection in the treatment of primary liver cancer.Methods From January 2005 to December 2013,a total of 84 patients diagnosed as primary liver cancer in our hospital were collected and divided into combination group(42 cases) and simple group(42 cases) according to the surgical method.Combination group were treated by combining liver resection with microwave ablation during operation,simple group by simple liver resection.Results The intraoperative blood loss for combination group was (323.9 ± 93.1) ml and simple group was (524.5 ± 119.2) ml,P ＜ 0.05.postoperative tumor recurrence rate for combination group was 14.2％ and simple group was 33.3％,P =0.040.1-,3-,and 5-year survival rate for combination group was 96.5％,67％ and 51％,and simple group was 84％,49.5％ and 36.5％,P =0.036.The differences of the above parameters between the two groups were statistically significant.The operation time for combination group was (177.7 ± 30.7) min and simple group was (165.1 ± 29.5) min,P =0.058.The postoperative hospital stay for combination group was (15.5 ± 3.7) d and simple group was (14.0 ± 4.0) d,P =0.068.The changes of ALT,AST,ALB,TBIL on the first postoperative day and the incidence of postoperative complications (including bile leakage,fever,pleural effusion,blooding,abdominal infection and some others) between the two groups had no statistical significances (P ＞ 0.05).Conclusion The curative effects of liver resection combined with microwave ablation during operation are superior to pure liver resection in the treatment of primary liver cancer.

The chemical structures of P1 A was identified by complete acid hydrolysis, partial acid hydrolysis, periodate oxidation-Smith degradation, methylation analysis, IR and NMR. The results showed that P1 A had a backbone consisting rhamnose, mannose, glucose and galactose. The side chain possessed arabinose and xylose. 1-->, 1-->6 and non-reducing terminal linkages existed in polysaccharide P1A, but there are doubling amount of 1-->2 and 1-->4 linkages. Oxidable linkage of P1 A accounted for 45%, and inoxidable linkage of P1A accounted for 55%. Mannose, glucose and galactose were mainly linked by 1-->2 linkage. Rhamnose, arabinose and xylose were mainly linked by 1-->2 and 1-->4 linkages. PlA contained beta-Glc(1,6)-,beta-Gal(1,3)-,beta-Man(1,4)-beta-Rha,-Glc(1,4)-, Glc(1)-,-Gal(1,4)- and Man(1)-.
Acanthaceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Molecular Weight ; Polysaccharides ; chemistry

OBJECTIVETo evaluate the value of brain natriuretic peptide (BNP) in estimating risk stratification in patients with acute myocardial infarction (AMI) and to determine the relationship between BNP and adverse cardiac events after AMI.

METHODSThe 135 subjects were selected into the study, including 25 healthy subjects and 110 patients with a first AMI. The plasma concentrations of BNP were measured at two to four days after infarction in patients and healthy controls. Left ventricular function was evaluated by echocardiography with the parameters of left ventricular ejection function (LVEF) after 3 months. Patients were followed up at 12 months. The main outcome measures were heart failure, left remodeling, mortality and other adverse cardiac events at one year.

RESULTSPlasma BNP concentrations in patients with AMI were much higher than those in the health control people (416.7 +/- 208.0 ng/L versus 61.8 +/- 34.1 ng/L, P < 0.01). The BNP count ranged from 5 to 2500 ng/L in AMI patients. There was no association between the BNP count and mortality rate. The development of new congestive heart failure (CHF) was associated with a higher BNP count (P = 0.02). The development of any of the clinical end points (death/CHF/shock) occurred more frequently in patients with a higher BNP count (13.8% for BNP count of < 100 ng/L, 39.1% for BNP count of 100 - 200 ng/L, 43.3% for BNP count of 200 - 400 ng/L, 46.4% for BNP count of > 400 ng/L; P = 0.019). Plasma BNP concentrations remained independently associated with the development of clinical end points in multivariable model that adjusted for potential confounding variables.

CONCLUSIONThe results of the present study confirm that the elevated BNP count related to the risk stratification and prognosis in patients with AMI. Elevations in BNP count are associated with a higher incidence of new CHF and adverse clinical outcomes after AMI. It could serve as a strong predictor for the subsequent development of poor outcomes in AMI patients.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; blood ; diagnosis ; Natriuretic Peptide, Brain ; blood ; Prognosis

Critical Illness ; Emergency Service, Hospital ; Humans ; Patient Safety ; Risk Factors

Objective To explore the value of dual-phase contrast-enhancement multislice computed tomography (MSCT) in the assessment of acute myocardial infarction volume and perfusion in porcine models. Methods The distal left anterior descending coronary arteries of 5 pigs were balloon-occluded for 90 min and followed by reperfusion. MSCT was performed 1 min (early phase) and 5 min (delayed phase) after administration bolus of 100 mL of iodinated contrast material 30 min after reperfusion. On the same day, hearts were excised, sectioned in 8 mm short-axis slices, and stained with TTC. Infarction volume was defined as the sum of the hyper-enhanced area and surrounding hypo-enhanced area in all slices on delay enhanced phase of MSCT and the TTC-negative area on TTC staining slices. Infarction volume was expressed as percentage of total slice volume. Results Acute infarction detected by MSCT was characterized by early myocardial perfasion defects in the early phase of the contrast bolus (early defects) with surrounding residual defects and late enhancement observed in the late phase. Mean CT attenuation value of early defects was significantly different from CT attenuation value of remote myocardium [(213±55)HU vs (304±30)HU](P < 0.05), CT attenuation values of residual defects and late enhancement were also significantly different from those of remote myocardium [(360±75) HU vs (90±37) HU and (152±23) HU vs (190±37) HU, repectively](P < 0.01, P < 0.05). The mean infarction volume was (8.9± 1.0)% on MSCT and (9.2±1.4)% on TTC pathology images. The infarction volume assessed by MSCT compared well with TTC staining slices. Conclusion Acute reperfused myocardial infarction zone has specific enhancement pattens different to remote normal zone on dual phase MDCT, which is in good agreement with in vivo Trc pathology in the assessment of acute reperfused myocardial infarction shortly offer reperfusion.

The three links theory applied in trauma emergency care system refers to an integrated system with the three important components of trauma emergency care system, viz. prehospital trauma services, hospital trauma services and critical care services. The development of the trauma emergency care system should be guided by the three links theory so as to set up a practical and highly efficient system: a prompt operating and monitoring transportation system, a smooth and real-time information system, a rational and sustainable system of regulations and contingency plans, and a system for cultivating all-round trauma physicians.
China ; Delivery of Health Care, Integrated ; organization & administration ; Emergency Medical Service Communication Systems ; organization & administration ; Emergency Medical Services ; organization & administration ; Emergency Medicine ; organization & administration ; Emergency Service, Hospital ; organization & administration ; Humans ; Models, Organizational ; Practice Guidelines as Topic ; Transportation of Patients ; organization & administration ; Wounds and Injuries ; therapy

OBJECTIVETo evaluate the efficacy of modified Gant-Miwa procedure with anal encircling for adults with rectal prolapse.

METHODSClinical and follow-up data of 31 adult patients with rectal prolapse undergoing modified Gant-Miwa procedure with anal encircling procedure between September 2005 and January 2012 were retrospectively analyzed.

RESULTSOperations were successfully performed in these 31 cases. The mean operation time was 75 (range 50-165) minutes. The mean estimated blood loss during operation was 50 (range 20-80) ml. There were no postoperative complications, such as hemorrhage, perianal abscess, anal fistula, intra-abdominal infection, or urogenital dysfunction, while only 7 patients developed urinary retention postoperatively. Rate of postoperative constipation improvement was 61.5% (8/13) and defecation difficulty improvement was 69.6% (16/23). Twenty-eight patients received anal manometry 2 months after operation and the result showed that rectal sensation threshold and rectal maximal tolerance decreased significantly, while anal resting pressure and anal squeeze pressure did not change significantly as compared to preoperative values. Six months after operation, anal function was Kirwan grade I in 22 cases and grade II in 8 cases. During a mean postoperative follow-up of 2.5 years (3 months-6.3 years), 2 of 26 patients developed recurrent prolapse.

CONCLUSIONSModified Gant-Miwa procedure with anal encircling for adults of rectal prolapse is a simple and safe procedure with low recurrence rate, minimal invasion, no serious complication and mortality, especially suitable for the elderly patients, accompanied with underlying diseases or reluctant to undergo transabdominal operation.

Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Digestive System Surgical Procedures ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rectal Prolapse ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo construct the localization system involving anti-TfR monoclonal antibody (McAb) and AFP promoters and assess its effect on human hepatoma cell lines.

METHODSThe conjugate of anti-TfR McAb and polylysine (PLL) was made by SPDP and purified by molecular screen chromatography. DNA blocking test determined that the ratio of one pEBAF/tk to six Ab-PLL was the most suitable to couple them. The pEBAF/tk recombinant plasmid bearing HSV-TK gene was coupled to Ab-PLL by noncovalent bond. The pEBAF/tk was transferred into human hepatoma cell line HepG2, SMMC7721 and pulmonary cancer cell line A549 by receptor-mediated gene delivery (Ab-PLL-DNA) and liposome procedure. The growth inhibitory rates of HepG2, SMMC7721 and A549 cells were measured by MTT assay.

RESULTSThe inhibitory rates of HepG2/tk in 100 mg/L and 1 mg/L of GCV were 60.5% and 24.3%, respectively. The inhibitory rate of GCV to SMMC7721 was 23.2% in 3 days. The pulmonary cancer cell A549, A549/tk (Ab) and A549 /tk (lipo) could not be inhibited by the addition of GCV.

CONCLUSIONThe localization system employed in this paper has high specificity, effectiveness and safety for gene therapy. It would be a promising strategy for gene therapy.

Antibodies, Monoclonal ; therapeutic use ; Carcinoma, Hepatocellular ; therapy ; Cell Line, Tumor ; Ganciclovir ; therapeutic use ; Genetic Therapy ; Humans ; Liver Neoplasms ; therapy ; Receptors, Transferrin ; immunology ; Simplexvirus ; enzymology ; Thymidine Kinase ; genetics ; alpha-Fetoproteins ; genetics