Objective To observe the changes of PI3K/Akt signaling pathway and endoplasmic reticulum stress related protein GRP78 and CHOP in CCl4 induced liver fibrosis and to explore their effects on hepatic fibrosis.Methods Thirty SD rats were randomly divided into normal control group, 4 and 8 weeks liver fibrosis group (hypodermic injection of 40% CCl4).Pathological changes of liver tissue was observed by HE staining.The techniques of real-time PCR was applied to detect mRNA of GRP78 and CHOP in liver.Detected expression of Akt1, phospho-Akt1, GRP78 and CHOP protein by western blot.Meanwhile, the cell apoptosis in liver was detected by TUNEL.Results Compared with the normal control group, GRP78 and CHOP mRNA and protein in 4 and 8 weeks liver fibrosis group was increased(P<0.05), while expression of Akt1, phospho-Akt1 in 4 and 8 weeks liver fibrosis group was lower than that in normal control group(P<0.05).Compared with normal control group, the apoptosis of hepatocytes in 4 and 8 weeks liver fibrosis group was elevated (P<0.05).Conclusions PI3K/Akt signaling pathway and endoplasmic reticulum stress may play important roles in the induction of apoptosis of hepatocytes in rats with hepatic fibrosis.

Objective To explore the feasibility of laparoscopic splenectomy (LS) in the management of ruptured spleen. Methods Laparoscopic splenectomy was performed in 8 cases of ruptured spleen in this hospital from August 2004 to May 2005. Results Laparoscopic splenectomy was accomplished successfully in 7 cases and a conversion to hand-assisted laparoscopic splenectomy (HALS) was needed in 1 case. The operation time was 150~200 min (mean, 180 min). The intraoperative blood loss was 600~5 500 ml (mean, 2 200 ml). There were 5 cases of type Ⅱ rupture and 3 cases of type Ⅲ rupture. The postoperative recovery was uneventful and no complications were encountered. Conclusions[WTBZ] Laparoscopic splenectomy is a safe and feasible option for the management of ruptured spleen.

In recent years, the number of ICU survivor is ever-growing with the increase of cure rate. The survivors′ outcome has aroused more and more attentions from medical personnel. ICU survivors tend to experience lasting physical, psychological and cognitive injuries, the post-traumatic stress disorder is one kind of significant psychological injury associated with patients′ critical experience. This review aims to summarize relevant literatures, introduces the prevalence, risk factors, complications, and interventions of ICU survivors′ post-traumatic stress disorder symptom, in order to prevent ICU survivors from post-ICU psychological injury and improve their long-term outcome.

Objective To analyze the relocation stress and its influencing factors of the families of patients transferred from ICU.Methods Totally 101 ICU patients' families were recruited by convenience sampling approach from three hospitals between October and December,2016.General information questionnaire and the relocation stress scale for the families of patients transferred from ICU were used to collect data.Results The relocation stress score was 55.49±6.30.The average score of the total items was 3.25±0.55.Multiple regression analysis showed that education level of family members,family members' gender,age of patients and the time of patients staying in ICU were main factors affecting the relocation stress of the families of patients transferred from ICU(P＜0.05).Conclusion The families of patients transferred from ICU have a certain intensity of relocation stress.Family members with low education level,being female,younger age of patients and long duration of staying in ICU have relatively high relocation stress.

0.05).The expression of bcl-2 in sham group was significantly higher than that in GC and ADX groups(P0.05)was observed.The ratio of bax to bcl-2 in sham group was significantly lower than that in GC and ADX groups(P

ICU treatment experience is the major source of patients′psychological stress as well as their relatives. Because of physical strain, sedation, invasive therapies, patients with critically ill usually tend to have some delusion, nightmare and memory loss, which cause several psychological disorder such as anxiety, fear and depression. The intensive care diary plays an important role in fill in memory gap , distinguish between delusion and reality ,make sense of illness experience, it is helpful to protect patients and their relatives from psychological disorders. Ever-growing scholars apply the intensive care diary to patients′post-ICU psychological rehabilitation. This review aim to introduce the concept, content, benefit as well as application status, provide some reference of the use in our country.

Objective To establish a cosmetic medicine bio-psycho-social model and its theory frame and a new clinical work system. Methods The clinical observation and clustering analysis were used in this study, which based on the modern medicine patterns to carry on the logical proof, theory derivation and systematic design. Results The bio-psycho-social model of cosmetic me dicine with combination of the theory and practice was established, including its concept, theory constitution and clinical work system. Conclusion The bio-psycho-social model of cosmetic medicine can most scientifically and comprehensively explain this discipline rule and clinical work, and it will bring the profound influence on the development of the theory and practice in cosmetic medicine.

MicroRNAs (miRNAs) , a species of small noncoding RNA, could regulate gene expression bv binding to the 3'-untranslated region of target mR NA at post-transcription level.MicroRNAs play important roles in various human biological processes such as differentiation, cell proliferation, and apoptoMs.Abnormal expression of miRNAs is implicated in carcinogenesis and progression of various cancers, indicating that miRNAs could be served as molecular biomarkers for diagnosis and treatment of cancer.In this resiew, the author summarize the most common altered miRNAs expression profiles and their possible roles in promoting cell proliferation, tumor metastasis,and chemotherapeutic resistance in gastric cancer.

Objective To probe into the efficacy and safety of lowering the temperatures of enteral nutrition in severe craniocerebral injury patients to prevent stress ulcer,and provide reference for patients with severe craniocerebral injury to choose appropriate enteral nutrition temperature. Methods The clinical randomized controlled trial was adopted.Numbered the patients by the order of being hospitalized, then divided the 84 patients with severe craniocerebral injury who were receiving enteral nutrition into experimental group and control group with 42 cases each.The constant temperature in experimental group was 22 ℃, and that in control group was 38 ℃. Observed and compared regularly the pH levels, occult blood test of gastric juice and defecate of the two groups within 7 days. Results After different temperature enteral nutrition,pH value of gastric juice of patients at 1,4,7 days after enteral nutrition was 2.610.37,4.550.35,4.870.34 in experimental group,2.210.44,3.930.22,4.180.30 in control group,there was significant difference between two groups (t=3.856, 8.185, 8.322, all P<0.01). There was no significant difference between two groups in the positive rate of gastric occult blood test(x2=0.102,0.408, 1.332, all P>0.05). There was no significant difference in the incidence of diarrhea and diarrhea start time between two groups (x2=0.288, t=0.372, all P>0.05). Conclusions Lowering the temperature of enteral nutrition has a certain protective effect on the gastric mucosa of patients with severe craniocerebral injury,which is helpful to prevent the occurrence of stress ulcer,and does not increase the risk of diarrhea.

Objective To evaluate the clinical effects of heated humidified high flow nasal cannula oxygen therapy on post-extubation intensive care unit(ICU)patients. Methods A computerized search was performed through Cochrane Library,EMBASE,PubMed,Elsevier,CNKI,Wanfang Database, SinoMed for randomized controlled trial(RCTs) which studied the effects of clinical effects of heated humidified high flow nasal cannula oxygen therapy on post-extubation ICU patients. Two reviewers separately searched the articles, evaluated the quality of the literatures, extracted date according to the inclusion and exclusion criteria. RevMan5.3 was used for Meta-analysis. Results Five RCTs were included involving 982 patients in the study. The Results of meta-analysis showed that the HFNC group was lower than COT group on the re-intubation rate (OR=0.39, 95% CI 0.25-0.62, P<0.05). About oxygenation index, comfort level and toleration of patients, HFNC group was superior to the COT group. Two groups had no significant differences(P>0.05)on post-extubation respiratory failure(OR=0.85,95% CI 0.35-2.09),respiratory infection(OR=0.69,95% CI 0.36-1.34),hospital length of stay(MD=0.51,95%CI-0.02-1.03), mortality of hospital (OR=0.81,95% CI 0.39-1.69). Conclusions The use of HFNC oxygen therapy can reduce there-intubation rate,improve oxygenation index,comfort level and tolerance on post-extubation ICU patients, while HFNC group has no significant impact on the post-extubation respiratory failure, respiratory infection, hospital length of stay, mortality of hospital compared with COTgroup. However, in view of the quantity and quality of study. More RCTs should be conducted to verify the results.