Alcohol Drinking ; adverse effects ; Cardiovascular Diseases ; etiology ; prevention & control ; Health Promotion ; Humans ; Risk Assessment

Objective To study whether clinical variables could be used to predict the presence of esophageal varices(EV). Methods One hundred and twenty-six patients with decompensated liver cirrhosis were enrolled. Upper endoscopy was performed to identify the EV. The spleen vein (SV), portal vein(PV), spleen index(SI), ascites was determined by ultrasenography. Platelct count(Pt), prothrombin time(PT) and liver function was determined. Results Ninety-five patients with EV, and 42 patients with severe EV. Patients with EV had significant larger SI and lower Pt. Pt and SI were predictive factors for the presence of EV. When SI≥66.9 cm2 and Pt≤89.0×109/L, they had a positive predictive value of 97.4% and 96.5%, and a negative predictive value of 55.4% and 59.8%, respectively. SI was the only predictive factor for the presence of severe EV. When SI≥82.6 cm2, it had a positive and negative predictive value of 89.2% and 75.4%. Conclusions Pt and SI are predictive factors for the presence of EV. SI is the only predictive factor for the presence of severe EV. Non-invasive factors SI and Pt can be used to predict the EV in patients with decompensated liver cirrhosis.

ObJective To explore the value of acute physiology and chronic health evaluation Ⅲ(APACHE Ⅲ ) score and the concentration of serum cholinesterase (ChE) in predicting the condition and prognosis of patients with severe acute pancreatitis (SAP) within 24 hours afar hospitalization.Methods Sixty-two SAP patients were enrolled and APACHE Ⅲ score was assessed and the concentration of serum ChE was detected within 24 hours after hospitalization.The correlation between the concentration of serum ChE,APACHE Ⅲ score and the condition and prognosis was analyzed.Results There were 44 survivalcases and 18 dead cases.The APACHE Ⅲ score of the surval patients was significantly lower than that of the dead patients [(52.16 ± 13.76) scores vs.(97.10 ± 15.85) scores] (P＜0.01).The concentration of serum ChE of survival patients was significantly higher than that of the dead patients [ (3685 ± 466) U/L vs.(2109 ± 345) U/L] (P＜ 0.01 ).The higher APACHE Ⅲ score was,the lower the serum ChE concentration was,and the higher the mortality rate was.APACHE Ⅲ score and the concontration of serum ChE both had statistical significances compared with the prognosis in the Logistic regression analysis (P =0.0043,0.0075);APACHE Ⅲ score (95％ CI 1.0306-1.1507),the concentration of serum ChE (95％ CI0.9986-1.0125 ).ROC areas under curve (AUC) of APACHE Ⅲ score,serum ChE concentration with the prognosis were 0.936 and 0.882,respectively.There was no significant difference (P=0.0820).In combined prediction of APACHE Ⅲ score and serum ChE concentration,AUC was 0.952,and its predicting accuracy was higher than either APACHE Ⅲ score or serum ChE concentration (P=0.0016,0.0027).Conclusions APACHE Ⅲ score and the concentration of serum ChE both are significantly correlated with the condition and prognosis of SAP patients.Their combined detection can significantly improve the accuracy of prognosis judgement and provide some clinical guidances for treatment.

dialysis.

Objective: To modify EBP(endotoxin binding peptide), clone and express the mutate of EBP gene and gain purified mEBP.Method: mEBPgene was cloned by PCR site-directed mutagenesis. PinpointXa-3/mEBP expression vector was designed to express human mEBP as a fusion protein in BL21 (DE3) pLysS. Digested engineering bacteria by lysozyme and collected inclusion bodies.Fusion protein was purified by Pinpoint TM Xa purification system and cleaved by factorXa,mEBP was purified by RP-HPLC. Results: Mutations at residues 5 and 18(Gln→Lys) was obtained by PCR site-directed mutagenesis, expressed and purified mEBP successfully.Conclusions: Obtaining of purified mEBP lay a foundation for its biological activity research.

The Her-2 proto-oncogene encodes a 185kDa transmenbrane glycoprotein p185 which has intrinsic tyrosine kinase activity. It is overexpressed in several malignant human tumors like breast cancer. A chimeric antibody by assembling a single-chain Fv antibody and a human IgG1 Fc fragment was constructed. This chimeric antibody reacts with tumor surface antigen p185c-erbB-2 specifically. In order to put the antibody into clinical application, two steps purification method was used to attain the antibody’s purity more than 95%. Both the lyophilized pharmaceutical formulations of the antibody were found. The formulations can keep the stability and activity of the antibody for at least one year. These results were the foundation of the chimeric antibody for cancer therapy.

Objective To evaluate the safety and clinical efficacy of system thrombolysis combined with percutaneous catheter thrombus fragmentation and thrombectomy for acute massive pulmonary embolism. Methods Ninteen patients with acute massive pulmonary embolism were treated with IVC filter placement, percutaneous catheter thrombus fragmentation and system thrombolysis combined with anticoangulation using low-molecular-weight heparin.Four of 19 patients underwent adjuvant Stranb Rotarex catheter thrombectomy.Results Twenty-one procedures were performed in 19 patients.Improvement of pulmonary artery patency and initial relief of symptoms immediately occurred in 18 of 19 patients after interventional therapy.The oxygen saturation increased from 86% to 97%.Pulmonary artery pressure decreased from 33? 5mm Hg(1mm Hg=0.133kPa)to 25?5mmHg after interventional therapy(t=13.2,P

Objective:To study the effect of total saponins on cerebral blood flow and vascular resistance in anesthetized dogs.Methods:Thirty hybrid dogs in either sex,with a body weight of(11?1.5)kg,were evenly randomized into 5 groups: negative control group(saline 5 ml/kg,ig),positive control(nimodipine 300?g/kg,iv),and 3 groups treated with total saponins (low-dose group[10 mg/kg,ig],middle-dose group[30 mg/kg,ig],and high-dose group[60 mg/kg,ig]).The dogs were anes- thetized with intravenous pentobarbital sodium(30 mg/kg).The right common carotid artery was exposed to measure the cere- bral blood flow,cerebral vascular resistance,blood pressure and heart rate using the MFV-3200 electromagnetic flow meter and MPA-3000 bioelectricity signal-amplifier.Results:Compared with negative control,cerebral blood flow was significantly in- creased in animals treated with asparagus root saponins(30 and 60 mg/kg,ig)during 5 and 120 min after drug administration (P

Objective To define the stages of medical rescue after earthquake or tsunami disaster and their significance.Method Three stages of medical rescue were defined according to the clinical features of diseases in 3-37 days after earthquake or tsunami in Pakistan and Indonesia.The classification of diseases was based on the criteria of disaster medical rescue set by World Health Organization.Five diseases including injuries/wounds,acute upper respiratory tract infection,acute hemorrhagic enterocolitis,acute enterecolitis and other diseases of internal medicine except epidemic or suspected epidemic diseases were employed to define the stages of disaster medical rescue.Results Injuries/wounds mainly occurred in 6 days after disaster.The incidences were 61.45% to 79.52% and 61.48% to 72.35% in Pakistan and Indonesia,respectively.The incidence of acute upper respiratory tract infection reached to a considerably high rate one week after disaster.Other diseases usually appeared one week later with incidence of 33.93% to 71.11% and 31.50% to 52.11% in Pakistan and Indonesia,respectively.The rate of acute hemorrhagic enterocolitis was 2%o in Indonesia whereas 35‰of acute enterocolitis was found in Pakistan.Conclusion Three stages of disaster medical rescue could be well defined.(1)Early or critical stage(in 6 days after disaster):Treatment of injuries/wound and resuscitation was the primary step to deal with.(2)Intermediate of subaeute stage(7-30days following disaster):The incidences of various kinds of diseases increased and more medical resources were needed in order to treat the upper respiratory tract infection and to lower the disable rate,and to prevent the prevalence of epidemic diseases.(3)Later or recovery stage(1-3months after disaster):The general condition of victims became even better than that of those affected by commonly occurred local diseases,and during this period,there were shortages of medical facilities and medical personnel.Therefore,supplement of medical resources was required.The well defined stages of medical rescue have an important significance for medical rescue teams to treat victims and prevent epidemic diseases more efficiently and timely,and also provide a guidance of scientific basis for the logistics officers of local government as well as our government to make a proper and reasonable distribution of medical resources,and dispatch and arrangement of medical rescue teams.This guidance also helps to make victims re- reliant.

Objective To evaluate the efficacy of the treatment of hilar biliary malignant obstruc tion with multiple stent drainage.Methods One hundred and twenty-seven patients with malignant biliary hilar obstruction were enrolled.The obstructions at the common hepatic duct within less than 1 cm to the junction of the left and the right hepatic duct were found in 66 cases,at the proximal common hepatic duct and the left and the right hepatic ducts in 45 cases,at the right hepatic duct in 5 cases and at the both left and right hepatic duets in 11 cases.Sixty-six patients received stent placement through the right biliary ducts and the common bile duct by puncturing the right mid-axillary line.The other 37 patients received 2 stents placement (disposed"Y"style) through the left and the right hepatic duct punc turing routway.Seven patients received 2 stents placement (disposed"┌"style) through the right hepatic duct and the common bile duct with a stent placed between the left and the right hepatic duct.Three patients had right hepatic duct stent placed first,followed by right hepatic duct and common hepatic duct stent. Twelve patients had stents placed in the right hepatic duct with external drainage from the left hepatic duct. Two patients had multiple strictures at the right hepatic duct,who got multiple external drainages.The total serum bilirubin levels were measured pre-and post-operatively.Results One hundred and twenty-seven patients with bi[iary obstraction had internal stents placed for drainage.The average total bilirubin levels among 121 patients were (283.4?175.4 )?mol/L pre-operation and (63.2?11.8)?mol/L post-operation (P