Objective To investigate the safe model to prevent and treat complications caused by various artificial liver support system(ALSS).Methods The complications in 191 patients with severe hepatitis during the ALSS(Including plasma exchange、plasma exchange associated with continuous venovenous hemofiltration、plasma exchange associated with hemodiafiltration、plasma exchange associated with plasma absorption、molecular absorbents recycling system) treatment were observed and analyzed. Results During the treatment 287 episodes occurred and the rate of complications was 50.44%(287/569).The clinical manifestation included rash,numbness/tetany,hypotension,blood clotting in the channel,chest distress, disequilibrium syndrome,errhysis on dwell catheter,effusion on dwell catheter.75.61% of these complications was caused by plasma exchange.The rate of complications was the lowest during the treatment of plasma exchange associated with hemodiafiltration.All of these complications got better after prompt sypotomatic therapies were taken.Conclusions Although the rate of complications was high during the treatment of ALSS,all of the complications got better after prompt sypotomatic therapies were taken.This therapeusis must be performed by intensive care.It is more safe than others during the treatment of plasma exchange associated with hemodiafiltration.

Objective To investigate bacterial distribution and antibiotic resistance pattern in NICU of Central Hospital of Anshan,Liaoning province of China.Methods We conducted a retrospective analysis of all the cases admitted to the neonatal intensive care unit(NICU) between November 2011 and November 2013.Culture and sensitivity data of organisms isolated were documented as well.Antimicrobial susceptibility of the isolated pathogens was determined with the use of the Kirby-Bauer disk-diffusion test.Results A total of 73 bacterial strains were isolated from 310 specimens with a 23.5％ positive rate.In total,37 Gram-negative strains were detected and Escherichia coli was the predominant infective organism,far more common than Klebsiella pneumoniae and Pseudomonas aeruginosa.Gram-positive organisms were isolated in 32 cases and the most common pathogen was Staphylococcus aureus,followed by Staphylococcus epidermidis.Fungal isolates were recovered in 4 cases and Candida albicans was the most frequently isolated fungal organism.Carbapenem-resistant was not encountered and Vancomycin-resistant Staphylococcus aureus was not detected.Staphylococcus epidermidis isolates were significantly more resistant than Staphylococcus aureus.Conclusion Escherichia colis,Staphylococcus aureus and Staphylococcus epidermidis were the major pathogens in NICU of our hospital,showing a steep increase in antibiotic resistance.Regular monitoring and rational evaluation of drug resistance may help reduce the spread of antibiotic resistance,and provide the basis for empirical antimicrobial use.

OBJECTIVE To investigate the significance of Epworth sleepiness scale(ESS)and modified Epworth sleepiness scale(MESS),and evaluate the feasibility of MESS in assessment of obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS The ESS and MESS of 232 patients with OSAHS was recorded in their first visiting.The scores of ESS and MESS were analyzed with the parameters of polysomnography(PSG). RESULTS Both ESS and MESS can reflect the degree of sleepiness and anoxemia in OSAHS patients,but the MESS was more efficient than ESS.The difference of MESS score between normal group and severe OSAHS group was greater than that of ESS score.CONCLUSION MESS is concerned the living habit of Chinese,and can partly reflect the station of patient with OSAHS.MESS can also be a primary screening method for suspected patients with severe OSAHS.

Objective To research etomidate or propofol in the whole intubation during the induction of elderly coronary heart disease autonomic nervous system function. Methods Ninety patients undergoing abdominal surgery patients with coronary heart disease were randomly divided into etomidate group (E group, 45 cases) and propofol group (P group, 45 cases). In pre-anesthesia, after the induction of anesthesia and after intubatiou with power spectral analysis of heart rate variability (HRPSA) observed in patients with heart rate variability (HRV) changes. Results After the induction of anesthesia, the low frequency(LF)[(316±301) ms2/Hz] end total power(TP)[(756±535) ms2/Hz] decreased significantly in E group(P<0.05) and LF, high frequency (HF), LF/HF ratio(LF/HF)and TP decreased significantly in P group [ (187±168) ms2/Hz, (89±48)ms2/Hz, 2.3±1.6 and (616±462) ms2/Hz] (P<0.05). The duction degree of LF, HF, TP and LF/HF in E group was more significant than that in P group (P<0.05). After intubation, LF, HF, LF/HF and TP increased significantly in both groups and no significant difference of HRV was observed between the two groups (P>0.05). Conclusions Propofol decreases the activity of autonomic nervous system, wherea etomidate produces minimal changes under anesthesia induction in elderly coronary heart disease patients.There is no remarkable difference in cardiovasological changes induced by etomidate and propofol during tracheal intubation.

Objective To explore the psychological stress of young nurses facing patients' death. Methods Young nurses in emergency department, ICU and hospice care ward (96 cases, research group) and young nurses in other departments(94 cases,control group)from 8 general hospitals were investigated by self-rating anxiety scale (SAS)and serf-rating depression scale (SDS).The results underwent comparison and analysis. Results SAS and SDS score,incidence of anxiety and depression in the research group were higher than those of the control group (P ＜ 0.05). Conclusions Young nurses who face patients' death frequently have high incidence rate of psychological stress.They show low psychological health level which deserves the close attention of nursing managers.

Objective:To study the expression of E-cadherin and P120ctn in nasopharyngeal carcinoma tissues, and to investigate their relationship and the relation with clinico-pathological features. Methods Two-step immuno-histochemical staining was applied to detect the expression of E-cadherin and P120ctn in formalin fixation and paraffin-embedded specimens from 56 cases with nasopharyngeal carcinoma and 15 cases with normal nasopharyngeal epithelia. Result:The abnormal expression rates of E-cadherin and P120ctn in the 56 cases of NPC tissues were 64.29% and 67.86% respectively, mainly with reduction of expression membrane and with the expression of cytoplasm; 6.67% of the 15 comparative normal cases of nasopharyngitis had abnormal expression of E-cadherin and P120ctn The differences were statistically significant. The abnormal expression rates of E-cadherin and P120ctn in NPC tissues were 71.43% and 85.71% respectively in low differentiated cancer group, which was obviously higher than the rates-42.86% and 36.29%-in high and middle differentiated cancer group. The 80.00% and 85.00% abnormal expression rate in the group with cervical lymph node metastases was higher than that in the group without cervical lymph node metastases(52.78%, 58.33%). The abnormal expression rate of E-cadherin and P120ctn(76. 92%,84.62%) in the third and forth phases was higher than that in the first and second phases (46.66%, 53. 33%). The differences were statistically significant (P<0.05). There were all together 12 co-expression cases of P120ctn and E-cadherin and 28 abnormal co-expression cases in the 56 cases of NPC tissues, which was of obvious consistency and correlation, with the relevant indexes: rs=0.5217 and P<0.01. Conclusion: The abnormal expression of E-cadherin and P120ctn is closely related to the degree of differentiation, clinical stage and cervical lymph node metastasis, and they join in the process of NPC initiation, progression, invasion and metastasis.

BACKGROUND: Polyvinyl alcohol (PVA) displays limitation to cell adsorbability. Can collagen improve the adsorbability of PVA to cells?OBJECTIVE: To develop a novel type composite of PVA and collagen, and explore the feasibility to serve as soft tissue substitute.DESIGN: Single sample observation.SETTING: Guangzhou Red Cross Hospital, Jinan University Medical College, Guangzhou Institute of Traumatic Surgery.MATERIALS: Fifteen New Zealand rabbits of 2.0-3.0 kg, either male or female, were provided by Medical Experimental Animal Center of Guangdong Province. The experiment was carried out in the Laboratory of Guangzhou Institute of Traumatic Surgery, and the experimental procedure was accorded with the animal ethical standards. Bovine typeI collagen was purchased from Guangzhou Trauer Biotechnology Co., Ltd. and PVA-124 from Guangzhou Chemical Reagent and Instrumentation Co., Ltd.METHODS: The experiment was performed in Guangzhou Red Cross Hospital, Jinan University Medical College between July 2003 and December 2006. ①Preparation of PVA-collagen material: 5 g/L bovine type I collagen was mixed with 5% PVA-124 at a ratio of 1 : 1. The mixture was freeze-dried at vacuum until becoming gelatinous. The internal structure was observed under the use of scanning electron microscope. ②Cytotoxicity test: PVA-collagen composite was cut into pieces of 10 mm×5 mm× 1 mm, put into 48-well culture plate after sterilized by Y ray, cultured with 1×104 3T3 cells in each well. Cell growth was observed under scanning electron microscope and laser scanning confocal microscope. ③Embedding test in vivo: Two longitudinal incisions were cut at the two sides of spine. The subcutaneous tissue was separated bluntly to form subcutaneous lacuna. Four pieces of PVA-collagen material were implanted in the lacuna and fixed. Nine specimens and the surrounding tissues were harvested from three rabbits each at one, four, eight and sixteen weeks postoperatively for pathological observation.MAIN OUTCOME MEASURES: The internal structure of gel film under scanning electron microscope, cytotoxicity test and embedding test in vivo results.RESULTS: ①Internal structure of PVA-collagen material:PVA-collagen material showed white gel shape after freeze-drying at vacuum. Penetrating three-dimensional pores were observed in the surface and inner section under scanning electron microscope. ②Cytotoxicity test results showed that 3T3 cells grew normally on the PVA-collagen material. ? Embedding test in vivo results suggested that one week after PVA-collagen implantation, foreign body reaction occurred, and the interface between material and tissue was clear. Four weeks later, only rare lymphocyte infiltration was observed, and a great amount of fibroblast hyperplasia formed collagen fibrils and false simple cuboidal epithelium coating material. In 8 weeks, no lymphocyte infiltration, neutrophilic granulocyte infiltration or foreign body giant cell were found; dense capsule wall and capsule coating material generated from a great amount of fibroblasts were observed. In 16 weeks, extending collagen fibrils were found arranged regularly with shrank nucleus, showing long ovoid or long fusiform in shape; no new formation small vessels, lymphocyte, neutrophilic granulocyte infiltration or foreign body giant cell infiltration were observed. The capsule wall was stable and thinned. CONCLUSION: PVA-collagen composite has good cell compatibility and tissue compatibility but no toxic or adverse effect. It can serve as in vivo implant.

AIM To observe Arg-Glu*ss activity of antiplatelet and anticoagulation in rats and to further explore its mechanism. METHODS Twenty four male sprague dewley rats were divided into three groups randomly (eight rats in each group).Each group was orally given Arg-Glu (61 4 mg?kg -1 ?d -1 ), ASA (36 mg?kg -1 ?d -1 ) and equal placebo solution respectively.Eight days later all rats were given anesthesia and blood was taken from abdominal aorta with a plastic catheter, then the indexes related to blood hemodynamics,coagulation and blood fibrinolysis were measured. Twenty four SD rats were treated in the same way mentioned above. Platelet aggregation was measured by turbidimetric method. Plasma level of cyclic GMP and prostacyclin was evaluated by radioimmunoassay and nitric oxide by spectrophotometric determination. Common carotid artery-external jugular vein bypass was established in another 24 rats, and the weight of wet thrombus was measured with high sensitive electrical scale. RESULTS In group of Arg-Glu, statistically significance decrease versus placebo group was observed on blood apparent viscosity, reduced viscosity, hematocrit and plasma viscosity, increase versus placebo was also observed on blood reciprocal calcium time, activated partial thromboplastin time and prothrombin time ( P 0 05). Platelet aggregation activation decreased compared with placebo 〔(0 75%?3.62%) vs (32 8%?6 62%) P 0 05)〕. CONCLUSION Arg-Glu with its properties of antiplatelet、anticoagulation and improvement of blood rheology status in rats could be regarded as one antiplatelet drug and one NO precursor .Its mechanism of action was thought to be by Arg-NO-cGMP metabolism pathway while other mechanism might be involved.

AIM:To develop a capillary GC method for determining six components in Heiguidou Oil,?-pinene,eucalyptol,borneol,methyl salicylate,cinnamia aldehyde and eugenol. METHODS:GC was applied to quantitative analysis. Chromatographic conditions consisted of PEG-20M(30 m?0.25 mm?0.25 ?m),flame ionization detector(FID),and programmed temperature; initiation temperature was at 80 ℃ for 7 min; the rate of temperature was 15℃/minute,final temperature was at 180 ℃ for 10 min,bypass rate was 50 ∶1. The sample dissolved in absolute alcohol. The external standard was used. RESULTS:The standard curves of conclusion ?-pinene,eucalyptol,borneol,methyl salicylate,cinnamia aldehyde and eugenol were linear within the ranges of 0.322-32.150 mg/mL,0.202 -20.215 mg/mL,0.126-12.630 mg/mL,0.633-63.290 mg/mL,0.174-17.390 mg/mL,0.633-63.290 mg/mL and 0.203-20.255 mg/mL,respectively.RSD were 0.83%,0.48%,0.48%,0.31%,and 0.53 %,respectively. CONCLUSION:The established method is accurate and it can be applied to the simulta-neous assay of six components.

Objective To establish mathematical model for the differential diagnosis of endoscopic gastric ulcerative lesions with the help of image processing software and statistical analysis method. Methods The microscopic images of 25 gastric ulcers and 25 gastric peptic cancers were collected from January 2013 to December 2013.Then the Photoshop CS4 software was used for image processing and representative measurements gathering(area,perimeter,roundness,height,width,gray scale,involving the density,color,lightness,pixels).Then the principal component analysis,the scatter plot and cluster analysis were performed by SPSS 16.0.Results According to the results of principal component analysis, Z1 showed a strong positive correlation with area,perimeter,height,width,cumulative density,pixel,which represented the shape statistics of ulcer.And Z2 showed a strong positive correlation with gray scale,color, lightness,which represented the color statistics of ulcer.On the Scatter plot,gastric peptic cancer images showed a stronger positive correlation with the principal component Z1 and Z2 .Clustering analysis results showed that for the majority of patients,there was a pattern in its incidence.In the gastric ulcer diagnostic models,the effective information should include area≤10 000;perimeter≤250;height≤90;width≤60;gray scale≥90;cumulative density≤190 000;color≥110;and lightness≥110(unit:pixel).In the gastric ulcera-tive cancers,the effective information should include area≥38 000,perimeter≥690,height≥300,width ≥ 426,gray scale ≤ 100,cumulative density ≥ 14 000 000,color ≤ 125,and lightness ≤ 130 (unit:pixel). Conclusion Among the endoscopic image data,area,perimeter,roundness,height,width,gray scale, cumulative density,color,brightness,pixels are important indices,which can contribute to the differential diagnosis of gastric ulcerative lesions.The established mathematical model based on the ten indices can be applied to predict and diagnose gastric ulcerative lesions.