0 05). No adverse reaction was seen in all patients. Our results suggest that intravenous Pantoloc is a good proton pump inhibitor in patients with duodenal ulcer combined with upper gastrointestinal bleeding, and it is similar to Losec in effectiveness and safety.

Objective To systematically evaluate the effects of albumin compared with crystalloids on fluid resuscitation for adults with severe sepsis and septic shock.Methods The six databases as follows:Cochrane Library,Pubmed,Embase,CNKI,VIP and Wanfang,were retrieved by computer,from their inception to November,2015.Randomized controlled trials(RCT) in the treatment of adult patients with severe sepsis and septic shock were included for quality assessment and Meta-analysis was performed by using RevMan5.3 software.Results A total of 4 RCTs involving 3 862 participants were included.No differences were found between albumin and crystalloids resuscitation with respect to 28-day mortality[RR=0.95,95%CI(0.86,1.05),P=0.33],90-day mortality[RR=0.95,95%CI(0.86,1.05),P=0.33],duration of stay in ICU,duration of hospital stay,duration of mechanical ventilation and renal replacement therapy.Conclusion In that meta-analysis,the effects of fluid resuscitation with albumin or crystalloids were not significantly different in adults with severe sepsis and septic shock.

Objective:To evaluate the efficacy and safety of capecitabine or S-1 combined with oxaliplatin or cisplatin in the treat-ment of advanced gastric cancer. Methods:Six databases including Cochrane Library, Pubmed, Embase, CNKI, VIP and WanFang were retrieved. Randomized controlled trials ( RCT) in the treatment of advanced gastric cancer were involved for the quality assess-ment and Meta-analysis. Results:A total of 14 RCT involving 1 051 patients were included. There were no significant differences in the total effective rate, complete remission rate and partial remission rate between the two groups(P>0. 05). In the safety evaluation, the incidence of hand-foot syndrome was higher in capecitabine-based regimens than that in S-1-based regimens[RR=2. 59,95%CI (1. 61,4. 17),P<0. 000 1], while the incidence of stomatitis was lower in capecitabine-based regimens[RR=0. 64,95%CI(0. 50, 0. 82),P=0. 000 4]. The other adverse reactions such as nausea and vomiting, diarrhea,neuropathy,dysfunction of liver and kidney, anemia, leukopenia, neutropenia and thrombocytopenia exhibited no significant differences between the two groups(P>0. 05). Con-clusion:Capecitabine combined with oxaliplatin or cisplatin has similar efficacy with S-1 combined with oxaliplatin or cisplatin in the treatment of advanced gastric cancer, and the incidence of hand-foot syndrome is higher in capecitabine-based regimens and the inci-dence of stomatitis is higher in S-1-based regimens.

AIM: To demonstrate the susceptibility of cell apoptosis varies during the progress of cell malig- nant transformation from human being in vitro. METHODS: A SV40T - transfected human bronchial epithelial im- mortalized cell line (called M) was selected in this work, which has acquired some characteristics of malignant trans- formation at the later passage. The alterations of apoptosis and bcl- 2, P53 genes between early and later passage of M cells were investigated by means of TDT labeling in situ, chromosome FISH, RNA and protein testing, etc. RE- SULTS: Incidence of apoptosis induced by cis - platin was significantly lower in later than in early passages of M. Levels of bcl - 2 mRNA and protein in later passages were higher than early passages of M, and overxpression of bcl -2 was accumulated following the development of cellular malignancy. P53 protein level was as high in early as in later passages. CONCLUSION: Overexpression of bcl - 2 decreases the cellular sensitivity to apoptotic inductors plays an important role during progress of carcinogenesis in human bronchial epithelial cancers. The inactivation of P53 protein in the SV40 - T transfected M cell line may be one of reasons of bcl - 2 overexpression, but not associated with the accumulation of bcl - 2 expressed level during cell transformation.

Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; Female ; Herbicides ; poisoning ; toxicity ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Paraquat ; poisoning ; toxicity ; Risk Factors ; Time Factors ; Young Adult

Objective To investigate work stress state of nursing home staff and to analyze the influential factors affecting work stress.Methods Stratified random sampling method was adopted to investigate 180 nursing assistants by self-designed questionnaire,Work Stress Scale(WSS),Simplified Coping Style Questionnaire and internal-external locus of control scale investigation.Results Totally 174 valid questionnaires were collected.Variance analysis revealed there were significant differences of age and other factors.Stepwise multiple regression analysis showed five variables entered the equation,including workexpenence education level number of the cared ages work scheduline coping stule and explain 56.7％ of the total variable.Conclusion Nurse managers should pay attention to and improve achievement sense and mental adjustment ability of nursing assistants,to build a well-organized support system to reduce the workload.

OBJECTIVE: To study the anti-tumor and immunological effect of extracts from Thymus quinquecostatus Celak on mice transplanted S180 tumor cells. METHODS: Different doses of volatile oil and alcohol extracted substances from Thymus quinquecostatus Celak were given to mice bearing S180 tumor for 9 days. Tumor inhibition rates and coefficients of spleen and thymus were determined. RESULTS: Tumor inhibition rates of the groups with alcohol extracts (40 g crude drug.kg(-1).d(-1) and 20 g crude drug.kg(-1).d(-1)) were 51.5% (P<0.01) and 36.4% (P<0.05) respectively, and those of the groups with volatile oil (40 g crude drug.kg(-1).d(-1) and 20 g crude drug.kg(-1).d(-1))were both 39.4% (P<0.05). CONCLUSION: The extracts from Thymus quinquecostatus Celak have anti-tumor activities. The coefficient of spleen in group with alcohol extracts (40 g crude drug.kg(-1).d(-1))was close to normal value, and its coefficient of thymus was between that of the negative control group and the group with cyclophosphamide (0.02 g.kg(-1).d(-1)). The anti-tumor activity of the alcohol extracts was significantly higher than that of the control group and the tumor inhibition rate was depending on drug concentration. Depending on index of immunity,the extracts from Thymus quinquecostatus Celak may have some influences on immunity.

Objective To discuss the timing and procedures of reoperations on the residual aortic dissection after initial ascending aortic operations on Stanford type A aortic dissection.Methods From March 2009 to November 2011,16 consecutive patients(13 males,3 females) underwent reoperations on the residual aortic dissection.The mean age was 44 years(23-61 years),8 cases was associated with Marfan syndrome.The right axillary artery or femoral artery cannulation was used for cardiopulmonary bypass,cerebral protection was achieved by unilateral antegrade brain perfusion and nasopharyngeal temperature was dropped to 20℃-25℃.The Sun's procedure (total arch replacement with stented elephant trunk implantation) was performed in all patients,concomitant procedure include aortic root replacement (Bentall procedune) in 3 patients,aortic root replacement and coronary artery bypass grafting (Bentall + CABG) in 1 patient,the coronary artery anastomotic leakage repair in 1 patient,mitral valve replacement (MVR) in 1 patient.Results The interval between two operations averaged(66 ±40)months.The means of cardiopulmonary bypass,cross clamp and selective cerebral perfusion times were(193 ± 49)minutes,(90 ±28) minutes and(22 ± 10) minutes,respectively.The mean time to tracheal extubation was(17 ± 10) hours.All patients survived from the operation.One patient suffered from temporary left lower limb paralysis and recovered after treatment during follow-up.Computed tomography angiography (CTA)of aorta was performed on each patient before discharged from the hospital:descending aortic true lumen was significantly expanded,thrombosis of false lumen was found near stent graft.The average follow-up time was 17 (3-42) months,one patient died of aortic rupture 3 months later,one patient underwent total thoracoabdominal aorta replacement 6 months later,one patient with descending thoracic aortic dilatation combined with endometrial tear underwent thoracic endovascular aortic repair.Conclusion Reoperation should be performed as the following condition:the annual growth rate of residual aortic diameter exceeds 0.5 cm/year,the maximal aortic diameter exceeds 5 cm.The Sun's procedure (total arch replacement with the elephant trunk implantation) is safe and effective in the treatment of residual aortic dissection,low mortality and complications was achieved by it,the mid-and long-term results need the further follow-up.

Objectives To prospectively investigate the diagnostic accuracy,image quality and radiation doses of prospectively ECG-triggered high-pitch spiral acquisition computed tomography coronary angiography (CTCA) using Flash dual-source CT for the diagnosis of significant coronary stenoses.Methods Seventy-three patients underwent both CTCA and CCA.CTCA was performed using a Flash dual-source CT system with data acquisition at a high-pitch of 3.4.CCA served as the standard of reference.Radiation dose values were calculated using the dose-length product.Results There were 925 vessel segments in 73 patients.(1)Diagnostic accuracy: the sensitivity,specificity and positive and negative predictive values were 93.2％ (164/176),96.4％ (722/749),85.9％ (164/191),98.4％ (722/734) for segment assessment and 98.4％ ( 123/125 ),87.4％ ( 83/95 ),91.1％ ( 123/135 ),97.6％ ( 83/85 ) for vessel assessment and 100％ (44/44),89.7％ ( 26/29 ),93.6％ ( 44/47 ),100％ ( 26/26 ) for patient assessment.( 2 ) Image quality: there were 2 coronary segments of right coronary artery and one segment of left circumflex artery with non-diagnostic image quality.There was no non-diagnostic image quality in left anterior descending artery.(3) Radiation dose: the effective radiation dose was ( 1.14 ± 0.10) mSv.Conclusions CTCA using the prospectively ECG-triggered high-pitch spiral mode of the Flash dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenoses at low dose.