OBJECTIVE:To explore the observation and nursing points of hemorrhage in intravenous thrombolysis after using alteplase. METHODS:128 patients underwent alteplase intravenous thrombolysis were selected as the research object. The occur-rence of hemorrhage in each part were observed within 48 hours after medication and nursed timely. RESULTS:128 patients re-ceived intravenous thrombolysis. 48 h later,26 patients suffered from hemorrhage complications (20.3%). Among them,there were 6 cases of nose bleeding (4.7%),8 cases of subcutaneous congestion (6.3%),6 cases of gingival bleeding (4.7%) and 6 cases of gastrointestinal bleeding(4.7%). There was no significant difference in the incidence of complications among those groups (P>0.05). The time of nose bleeding was (3.2 ± 1.3) h,the time of subcutaneous congestion (3.5 ± 1.2)h,the time of gingival bleeding(1.5±0.7)h,and the time of gastrointestinal bleeding(4.1±1.8)h. The time of gingival bleeding was earlier than that of other groups,with statistically significant difference(P<0.05). There was no statistically significant difference among other groups (P>0.05). CONCLUSIONS:In alteplase intravenous thrombolysis,nurses should closely monitor hemorrhage and complications, especially the complication of gingival bleeding. Find out the complications timely and nurse it as early as possible.

Objective To investigate the effects of different concentrations of sevoflurane on adhesion and expression of CD24 and CD44v6 in human lung cancer cell line A549.Methods Human lung cancer cell line A549 was obtained from Shanghai Cell Biology Medical Research Institute,Chinese Academy of Sciences and cultured in RPMI1640 culture medium containing 10％ fetal calf serum.The cells were inoculated in 24 well culture plate.After being cultured for 24 h,the cells were randomly divided into 4 groups:control group (group C) and 3 sevoflurane groups exposed to 1.7 ％,3.4 ％ and 5.1％ sevoflurane for 2,4 and 6 h respectively ( groups S1,S2,S3 ).The cells were cultured for another 48 h.Cell adhesion rate was detected by adhesion test and the expression of CD24 and CD44v6 mRNA and protein was determined by RT-PCR and flow cytometry.Results Sevoflurane significantly inhibited the cell adhesion rate and down-regulated CD24 and CD44v6 expression in a concentration and duration of exposure-dependent manner.Conclusion Sevoflurane can inhibit cell adhesion through down-regulation of CD24 and CD44v6 expression.

As unrelated allogeneic umbilical cord blood transplantation (UCBT) has been developed for 20 years already since 1988, more than ten thousands cases have cumulatively undergone UCBT over the world. A huge number of clinical data confirmed that UCBT had unique characters with low rate of severe GVHD. The efficacy and data on TRM, relapse and EFS of allogeneic UCBT with HLA 0-1 mismatched are similar to those in HLA matched BMT. UCBT has become the optimal choice for source of hematopoietic stem cells for allogeneic stem cell transplant especially when HLA-matched or haploidentical donors are not available in time. In most developed countries, unrelated allogeneic UCBT developed successively, and in recent years HLA mismatched UCBT with double units performed in adults increased even more rapidly than in children. Another recent trend of UCBT has been extending to treat some non-malignant but refractory diseases in pediatrics, such as severe combined immunodeficiency, thalassemia major, bone marrow failure syndrome and metabolic disorders. The clinical successful practice of double units for cord blood transplantation inspires to ponder over questions remaining mystery. What is the conflict like between two mismatched donor cells in vivo, which does not spoil the whole transplantation but enable the patient to be engrafted successfully without any increment of the dosage by the sum of two doses together? How can they both be taken at the same time firstly by the recipient, but why does only one predominate later? What are the factors enable the donor cells of the winner to sustain? With the references of the international experiences, how to solve the clinical encountered problems, perspective of unrelated allogeneic UCBT and proper strategies to be enacted are reviewed.
Cord Blood Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Tissue Donors ; Transplantation, Homologous

Objective To evaluate the effect of tetramethyl pyrazine(TMP)on noise induced hearing loss (NIHL) in hypobaric environment. Methods Normal guinea pigs were randomly divided into two groups, in which the animals were exposed to noise for 1 day or 7 days, respectively. Each group was randomly divided into 3 subgroups: control, TMP-treatment and TMP-pretreatment groups. All animals were exposed to 110dB white noise in hypobaric chamber to repreduce a low pressure environment of 5500m altitude. The mechanism underlying TMP protection was studied by detecting the auditory brainstem response (ABR). Results ABR threshold shift in different degrees occurred in every group, especially in animals exposed to 4kHz. The threshold shifts increased in extent along with prolongation of exposure time. The longer they were exposed, the more ABR threshold shifts. ABR threshold shifts occurred more severely in control group compared with the two TMP-utilized groups. Conclusion TMP has certain protective effect on NIHL in a hypobaric environment.

Objective To explore the effect of diammonium glycyrrhizinate(DG) and astragalus membranaceus (AM) injection on the clinical comprehensive score in patients with acute lung injury (ALI). Methods According to the random number table method,a prospective random controlled study was conducted in which 60 cases of patients with ALI were divided into a study group and a control group(each,30 cases). Both groups received a comprehensive treatment based on the new guidelines,and the study group was additionally given DG and AM injection(DG 150 mg+AM 20 ml)one time per day for 7 days. The scores of lung injury,acute physiology and chronic health evaluationⅡ(APACHEⅡ)and systemic inflammatory response syndrome(SIRS)were measured at baseline,3rd and 7th day after treatment,and ventilation support time and final disease mortality rate were also calculated in all the patients. Results There were no statistically significant differences between the two groups in the scores of lung injury,APACHEⅡand SIRS before treatment and after treatment for 3 days(all P>0.05),with prolonged treatment,the above indexes were significantly reduced compared with those before treatment in the two groups,and the decreases in scores of indexes in study group was more significant than those in control group after treatment(lung injury score:1.31±0.99 vs. 2.29±1.08,APACHEⅡscore:18.43±8.17 vs. 24.23±6.98,SIRS score:1.69±0.89 vs. 2.60±1.04,all P<0.01). The time(hour)for ventilator support in study group was shorter than that in the control group(176.10±57.81 vs. 286.07 ± 156.27,P<0.01),but there was no statistically significant difference in mortality rate between the two groups(13.33%vs.16.67%,P>0.05). Conclusion The results suggest that DG and AM injection improve the scores of lung injury,APACHEⅡand SIRS,and alleviate the lung injury,so that the injection is beneficial to the early weaning from the ventilator to support treatment in patients with acute lung injury,and has certain therapeutic effect on ALI.

Objective To investigate the effects of sevoflurane on inhibition of growth of human lung adenocarcinoma A549 cells by cisplatin and γ ray.Methods The human lung adenocarcinoma cell line A549 was seeded in culture plate.After being cultured for 24 h,the cells were randomly divided into 6 groups (n =6each):control group (group C),sevoflurane group (group S),cisplatin group (group D),cisplatin + sevoflurane group (group DS),γ ray group (group R) and γ ray + sevoflurane group (group RS).A549 cells were exposed to 2.5% sevoflurane for 4 h in group S.Cisplatin with the final concentration of 3 mg/L was added to the culture medium and the cells were then incubated for 4 h in group D.Cisplatin with the final concentration of 3 mg/L was added to the culture medium and the cells were then exposed to 2.5 % sevoflurane for 4 h in group DS.A549 cells were exposed to γ irradiation (2 Gy) for 4 h in group R.A549 cells were exposed to γ irradiation (2Gy) and to 2.5% sevoflurane for 4 h in group RS.The cells were cultured for another 24 h after the end of treatment,the colony formation was detected and the rate of colony formation was calculated by colony formation assay.Proliferation of A549 cells was measured by plate colony formation and MTF assay and the rate of proliferation inhibition was calculated.Cell apoptosis was detected with flow cytometer.The expression of X-linked inhibitor of apoptosis protein (XIAP) and caspase-3 was detected by Western blot.Results Compared with group C,the rate of colony formation was significantly decreased,the rate of proliferation inhibition and percentage of apoptotic cells were increased,XIAP expression was down-regulated and caspase-3 expression was up-regulated in groups S,D,DS,R and RS (P ＜ 0.05).The rate of colony formation was significantly lower,the rate of proliferation inhibition and percentage of apoptotic cells were higher,XIAP expression was lower and caspase-3 expression was higher in group DS than in groups S and D,and in group RS than in groups S and R (P ＜ 0.05).Conclusion Sevoflurane can enhance cisplatin and γ ray-induced inhibition of growth of human lung adenocarcinoma A549 cells,and downregulation of XIAP expression and up-regulation of caspase-3 expression may be involved in the mechanism.

Objective To investigate the prognostic value of heart rate turbulence (HRT) in patients with chronic heart failure (CHF). Methods From October 2006 to May 2009, a total of 96 elderly CHF inpatients were selected, and the clinic data were recorded. Based on the echocardiogram and dynamic electrocardiogram, the differences of sinus HRT index of patients with different cardiac function classification were analyzed. During 9-28 months medical follow-up, the treatment endpoint was death from heart disease. Based on Logisitc regression, the prognostic values of HRT, age, hypertension, diabetes, myocardial infarction (MI), left ventricular ejection fraction, ACEI and β- adrenergic blocker for death of CHF patients were analyzed.Results There was no significant difference in HRT between grade Ⅱ and grade Ⅲ cardiac function (χ~2 = 1.60, P>0. 05), and between grade Ⅲ and grade Ⅳ cardiac function (χ~2 = 1.43, P>0. 05). But there was significant difference in HRT between grade Ⅱ and grade Ⅳ cardiac function patients χ~2 =9.84, P<0. 05), and HRT was weaken in grade Ⅳ group. The average follow-up time was (18. 0±9.6) months. Of all 96 patients, there were 34 dead of heart disease. There were correlations of death of CHF with HRT, low LVEF (≤ 45%), age (≥65 years), diabetes, MI and classification of heart function. Conclusions The sinus HRT in CHF patients has a favorable prognostic value.

Objective Testing the CRP and PLT for patients with acute myocardium infarction(AMI) .Analysising the relation‐ship between AMI and CPR or PLT .Methods We chose 60 patients with AMI who treat in our hospital during 2012/11 and 2014/10 as an observation group .As the same time ,we also chose 60 healthy person as a comparison group .Testing the CRP and PLT of the two groups with the same method ,and then we compare and analysis the results .Results The observation group's concentration of CRP is (22 .13 ± 4 .71)mg/L ,level of PLT is (241 ± 33)× 109/L .The comparison group's concentration of CRP is(2 .74 ± 0 .49) mg/L ,level of PLT is(162 ± 26) × 109/L .The result of the observation group is obvious higher than the comparison group ,and the difference is significance(P<0 .05) .The observation group's positive rate of CRP is 73 .33% ,increase of PLT is 38 .33% .The comparison group's positive rate of CRP is 3 .33% ,increase of PLT is 5 .00% .The result of the observation group is obvious higher than the comparison group ,and the difference is significance(P<0 .05) .Conclusion To the clinical diagnosis of AMI ,testing the CRP concentration and the PLT level is useful to understand the patient's host defenses and inflammation condition .It has clinical value to AM I's prevent ,diagnosis and prognosis .

AIM: To investigate the expression of stem cell factor (SCF) in tryptase -positive mast cells ( MCs) in different types of human periapical diseases for determining the role of SCF and MCs in the pathogenesis of peria-pical diseases.METHODS: A total 50 cases of specimens were involved in this study, including healthy control (n=20), periapical cyst (n=15) and periapical granuloma (n=15).The tissue material was fixed in 10%formalin for at least 48 h, stained with hematoxylin and eosin for the observation of histopathology, stained with immunohistochemistry for identifying MCs and MCs degranulation, and stained with double immunofluorescence for identification of tryptase-SCF double positive MCs.RESULTS:Compared with healthy control, significantly higher densities of both total and degranu-lated MCs in human periapical lesions were observed.The densities of both total and degranulated MCs in the periapical cyst were significantly higher than that in the periapical granuloma.The density of tryptase-SCF double positive MCs in the periapical lesions was significantly higher than that in the healthy controls.The density oftryptase-SCF double positive MCs in the periapical cyst was significantly higher than that in periapical granuloma.No significant difference in the density of MCs between immunohistochemistry staining and double immunofluorescence staining was observed.CONCLUSION:The tryptase-SCF double positive MCs play an active role in the pathogenesis of the periapical inflammatory lesions, particularly in the formation of fibrous tissue in periapical cyst.The potential role of the tryptase-SCF double positive MCs relates with the initiation, development, and persistence of the periapical inflammatory process.

Objective To establish a flow cytometry-based assay for the detection of monocyte-me-diated antibody-dependent cell-mediated cytotoxicity ( ADCC ) .Methods P815 cells double stained with PKH26 and carboxyfluorescein succinimidyl ester ( CFSE ) were used as target cells and coated with P 815 specific antibodies to form antigen-antibody complexes .The peripheral blood mononuclear cells were isolated as effector cells and co-cultured with the antigen-antibody complexes .The CD3-CD14+PKH26+CFSE-cell population were gated by flow cytometry .Optimized effector/target cell ratio and incubation time for killing assay were identified .Monocyte-mediated ADCC in 23 patients with chronic HCV infection and 22 healthy subjects were analyzed .Results The monocyte-mediated ADCC could be evaluated through analyzing the CD3-CD14+PKH26+CFSE-cells with flow cytometry .The optimized effector/target cell ratio was 10 ∶1 and the optimized time for incubation was 4 h.Monocyte-mediated ADCC was inhibited in patients with chronic HCV infection as compared with healthy subjects (P=0.009).Conclusion A flow cytometry-based assay for the detection of monocyte-mediated ADCC was established , which could be used as a fast , sensitive and safety method for the evaluation of monocyte-mediated ADCC during viral infections and the research and de-velopment of drugs .