Objective To evaluate the effectiveness of mouth care combined with intestinal and endoscopic working channel washing for ERCP related cholangitis.Methods A total of 573 patients diagnosed as having obstructive jaundice were randomized into three groups,190 cases in the control group,192 in the saline group and 191 in the amikacin group.Clinical and laboratory data were collected before ERCP and ERCP related cholangitis were recorded.Results There were no significant differences among the three groups in sex,age,the level of obstruction,the category of obstruction,total bilirubin or WBC counting.The incidences of ERCP related cholangitis were 21.1％ (40/190),13.5％ (26/192) and 4.7％ (9/191)in control group,saline group and amikacin group respectively,which was significantly different (x2 =22.409,P =0.000 ).The incidences of ERCP related cholangitis were 19.5％ ( 65/333 ) and 4.2％(10/240) in patients diagnosed as having hilar duct obstruction and low positioned biliary obstruction respectively (x2 =27.175,P =0.000).There was no significant difference in ERCP related cholangitis between benign and malignant biliary obstruction.Subgroup of hilar duct obstruction showed the incidences of ERCP related cholangitis were 29.7％ (33/111 ),20.5％ (24/117)and 7.6％ (8/105)in the control group,the saline group and the amikacin group,respectively (x2 =16.905,P =0.000).Conclusion The incidence of ERCP related cholangitis is relatively higher in patients with hilar duct obstruction.Mouth care combined with intestinal and endoscopic working channel washing can effectively reduce the incidence of ERCP related cholangitis,especially in the amikacin group.

ObjectiveTo study the potential of using temporal clustering analysis(TCA)technique in localizing an epileptogenic zone.MethodsTwelve patients with epilepsy were examined using resting functional MRI(fMRI). The patients had detectable focal lesions on cranial MRI.TCA was performed to analyze resting fMRI data in order to identify the timing of interictal epileptiform discharges (IEDs).Standard event-related fMRI analysis in SPM99 was used to generate maps of the activation induced by epileptic brain activities.Comparisons were made between TCA Resultsand SPM motion trochoid.ResultsEight of the twelve subiects showed activations in the brain regions that were consistent with those lesions determined on anatomic MRI.The remaining four subiects showed no clear activation in the areas of detectable lesions. In addition, correlation was found between TCA Resultsand motion trochoids.ConclusionsTemporal cluster analysis,an exploratory data-driven technique,may provide the timing information about interictal epileptiforill discharges.However,the Resultsfrom this novel fMRI analytical technique need to be interpreted with caution as it is vulnerable to motion artifact.

Objective To establish a rat skin organ culture model to study the initiation of hair follicle morphogenesis, and the dynamic expression of Wnt10b/β-catenin in the developing hair follicle. Methods The dorsal skins of SD rat at embryos 14-17 (E14-E17) were cultured on a gelatin sponge-supported tissue culture system at the air/liquid interface of DMEM with 10 % fetal bovine serum (FBS) for 3-6 days, some of which removed from El5 were cultured in DMEM with FBS of different concentrations. HE staining and fluoroimmunoassay were adopted. Results The model we established allowed skin tissues isolated from E14-E15 to develop in a manner that was histologically and temporarily similar to the process in vivo. However, the developing hair follicle ceased to continue when their morphogenetic process reached the forth stage, and the concentration of FBS did not show any significant effect on the development of hair follicle. Expression of Wnt10b/β-catenin was induced in culture, as it also occurred in vivo,but grew weak till it disappeared in culture for 6 days, which was accompanied by development halt of hair follicle. Conclusions A rat skin organ culture model is established in which the morphogenesis of hair follicle takes place in a manner similar to in vivo, and Wnt10b/β-catenin probably has a close connection with the early morphogenesis of hair follicle.

Objectives To investigate the clinical features of pneumonia in children with elevated alanine aminotransferase(ALT). Methods Clinical and laboratory data of 3 979 children with pneumonia admitted to the hospital were collected and retrospectively analysed, and ALT was detected in all cases. Results In 3 979 children with pneumo-nia, elevated ALT (13.78%) was found in 548 cases, most of which had mildly elevated ALT and were infants less than 6 months. The average age in elevated ALT group was less than that in normal ALT group (P=0.000). Apart from the symp-toms of pneumonia, most of them had non-specific clinical symptoms, 169 cases (30.84%) with anorexia or feeding dif-ficulties. 22 cases (4.01%) with poor spirit or weak, 10 cases (1.82%) with crying or abdominal pain;6 cases (1.09%) with dark urine; 4 cases (0.73%) with skin and/or sclera jaundice, 2 cases (0.36%) with bleeding tendency. Children in mildly elevated ALT group recovered faster than in moderate-to-severe elevated ALT group. Conclusions Mildly elevated ALT was most common in pneumonia with elevated ALT which was more likely to occur in younger age group. Clinical mani-festations were often non-specific with good outcomes.

Objective:To analyze the relationship between hepatitis B virus(HBV)gene mutation at 1896 in precore region with genotype and replication of HBV and the liver function of patients.Methods:HBV precore 1896 site mutation,the genotype of HBV and serum content of HBV DNA were determined by PCR in 60 patients positive of HBV DNA.Chemiluminescence miacropaticle immunoassay(CMIA)was used for detection of serum HBeAg and HBeAb.Liver function parameters were ob- tained by routine biochemistry method.Results:The alanine aminotransferase(ALT)level in HBV with 1896 site mutation was significantly higher than that in the wildtype virus.Site mutation at 1896 had no correlation with HBeAg,HBV genotype and HBV DNA content.HBV DNA content in patient with genotype C was significantly higher than that with genotype B(P

Objective To define the assessment dimensions of community-based elderly care service.Methods Firstly 11 assessment dimensions of elderly care service needs were teased out through literature review and group discussion, these were illness, self-care ability, vision, risk of falls, willingness/information self-expression ability, the comprehension in others' willingness/information, depression, anxiety, family care ability, self-desires for old-age support, family-desires for old-age support.Then 37 experts were invited to reconfirm and empower theose assessment dimensions with two rounds of Delphi method.Results Results showed that the enthusiasm and authority degree of experts were favorable in two rounds, and the results from the second round showed strong opinion coordination.Finally, 12 assessment dimensions were confirmed, in which financial situation of the aged added and used for reference.After weight calculation, illness was weighted the highest (0.11), while vision and the degree of anxiety were weighted lowest in 11 dimensions (0.07).Conclusion The reliability of the assessment dimensions of the aged service needs is high.This study had positive significance on the solution of the dilemma in elderly care at the present stage.

ObjectiveTo explore the possibility of repairing sciatic nerve gap of rats with artifical nerve graft.MethodsA novel artifical nerve guide was developed and used to suture the 15 milimeter long right sciatic nerve gap of 10 rats, other 7 rats were the control with the right sciatic nerve gap alone.2 and 4 monthes after operation, immunohistochemistry, Osmium staining, Bodian staining,motor end plate staining,WGA-HRP stain tracing have been done to observe the effect of repairing.Results2 months after operations, the sciatic nerve gap were repaired by the regeneration nerve.There was not evident inflammation in the defects.ConclusionsThe artifical nerve graft can induce the nerve to regenerate.

Objective To explore the inflammatory mechanisms of pulmonary embolism ( PTE ) and/or deep venous thrombosis ( DVT ) in elders secondary to chronic obstructive pulmonary disease ( COPD) exacerbation.Methods A total of 26 elders with acute exacerbation of high-risk COPD secondary PTE and/or DVT and 26 patients with low-risk COPD during stable phase diagnosed during the period of January 2008 to December 2012 were enrolled.The relevant parameters of routine blood examination , blood viscosity, D-dimer, fibrinogen ( FIB), arterial blood gas, blood cytokine, erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP ) were retrospectively analyzed.Results The major nonspecific symptoms were cough, sputum and dyspnea.The mean of neutrophile percentage (N%), D-dimer, FIB, interleukin-6 (IL-6), tumor necrosis factor (TNF), C-reactive protein (CRP), low and high shear blood viscosity in blood samples of patients with acute exacerbation of high-risk COPD secondary PTE and ( or ) DVT were higher than those of the control group ( t =3.339, 2.700, 2.207, 2.431, 2.257, 2.143, 2.223, 2.797, all P<0.05).However arterial partial pressure of oxygen ( PaO2 ) was lower than that of lower-risk COPD patients (t=4.312, P<0.05).IL-6 in blood of patients with acute exacerbation of high-risk COPD secondary PTE and ( or) DVT was positively correlated with low-shear blood viscosity , D-dimer and FIB (r=0.437, 0.624, 0.429, all P<0.05).TNF in blood of patients with acute exacerbation of high-risk COPD secondary PTE and ( or ) DVT was positively correlated to FIB , low and high cut blood viscosity ( r =0.624, 0.519, 0.513, all P <0.05 ).Plasma CRP in blood of patients with acute exacerbation of high-risk COPD secondary PTE and/or DVT was positively correlated with D-dimer, FIB, IL-6 and TNF ( r=0.478, 0.541, 0.533, 0.491, all P<0.05).Conclusions Inflammation may exist in elders with acute exacerbation of high-risk COPD secondary thrombotic disease.IL-6 and TNF may promote thrombosis secondary to acute exacerbation of COPD disease.Early screening and/or prophylactic anticoagulation are necessary for prevention.

OBJECTIVETo determine the relationship between DNP level after human severe brain injury and hyponatremia as well as isorrhea.

METHODSThe peripheral venous plasma as control was collected from 8 volunteers. The peripheral venous plasma from 14 severe brain injury patients were collected in the 1, 3, 7 days after injury. Radioimmunoassay was used to detect the DNP concentration. Meanwhile, daily plasma and urine electrolytes, osmotic pressure as well as 24 h liquid intake and output volume were detected.

RESULTSThe normal adult human plasma DNP level was 62.46 pg/ml+/-27.56 pg/ml. In the experimental group, the plasma DNP levels were higher from day 1 to day 3 in 8 of the 14 patients than those in the control group (P(1)=0.05, P(3)=0.03). Negative fluid balance occurred in 8 patients and hyponatremia in 7 patients. The increase of plasma DNP level was significantly correlated with the development of a negative fluid balance (r =-0.69, P<0.01) and hyponatremia (chi(2) =4.38, P<0.05).

CONCLUSIONSThe increase of plasma DNP level is accompanied by the enhancement of natriuretic and diuretic responses in severe brain-injured patients, which is associated with the development of a negative fluid balance and hyponatremia after brain injury.

Adult ; Brain Injuries ; blood ; complications ; Elapid Venoms ; blood ; Female ; Humans ; Hyponatremia ; etiology ; Intracranial Hypertension ; blood ; etiology ; Male ; Middle Aged ; Peptides ; blood ; Reagent Kits, Diagnostic ; Water-Electrolyte Imbalance ; blood

The aim of this research was to understand the influence of rhG-CSF on the sphingosine kinase (SphK) activity of monocytes. The peripheral blood monocytes were collected from 6 peripheral blood progenitor cell donors on the fifth day of mobilization with rhG-CSF and from 5 blood donors' buffy coats. The mRNA expressions of monocyte G-CSF receptor and SphK were tested with RT-PCR. The changes of SphK activity of monocytes were assayed after being treated with rhG-CSF. The results showed that the two kinds monocytes collected from both blood donors and peripheral blood progenitor cell donors mobilized with rhG-CSF expressed mRNA of G-CSF receptor and SphK. The SphK activity of monocytes collected from blood donors was not changed significantly after being treated with rhG-CSF (P > 0.05). The SphK activity of monocytes collected from peripheral blood progenitor cell donors transiently increased by (39.6 - 87.2)% after being treated by means of rhG-CSF (P < 0.05) without obviously dose-dependent effect. It is concluded that the SphK activity of monocytes collected from peripheral blood progenitor cell donors can be activated by rhG-CSF.
Granulocyte Colony-Stimulating Factor ; pharmacology ; Hematopoietic Stem Cell Mobilization ; Humans ; Monocytes ; cytology ; enzymology ; Phosphotransferases (Alcohol Group Acceptor) ; drug effects ; metabolism ; Receptors, Granulocyte Colony-Stimulating Factor ; biosynthesis ; genetics ; Recombinant Proteins