In this paper, we non-invasively measured PCWP and PAP using the parameters of echocardiography and routine heart film in 21 patients with dilated cardiomyopathy and compared the results with those of Swan-Ganz taken at the near time. The regression formula of PCWP and PAP obtained respeatively from the dimension of left atrium and index of cardiac area for PCWP and the dimension of left atrium, index of cardiac area and width of right inferior pulmonary artery for PAP can correctly reflect the pressures.

Objective] To explore the nursing method and effect of traditional Chinese medicine wet compress for the treatment of the disease of the blood vessel. [Method]Selects the hospital March 2013 to January 2015 ,a total of 96 patients with confirmed thrombotic occlusion vasculitis with the first period and the second period of patients, who were randomly divided into treatment group and control group, 48 cases in each, two groups at the same time, the routine nursing and the context of Mailuoning 30ml IV drip, treatment group based on the Tougu Tongmai Recipe wet applied external treatment, combined with TCM syndrome nursing. Two groups for 1 month for a course of treatment, observation of cold pain in the limbs, gap of claudication, soreness and numbness symptoms and treatment of total efficiency; readmission after followed up to observe the recurrence(deterioration), statistical analysis of parallel. [Results] The total effective rates of treatment group and control group were 95.8% and 68.75% respectively, the difference was statistically significant(P<0.05); the difference between the two groups was statistically significant(P<0.05); the difference between the two groups was statistically significant(P<0.05). [Conclusion] Compared with Mailuoning injection in the treatment of, Speranskia through vein wet compress external treatment nursing can effectively improve the thrombus occlusive vasculitis in patients with limb peripheral blood circulation, also can better reduce the recurrence rate, slow the progression of the disease, so as to achieve the purpose of disease treatment.

Objective To evaluate the clinical effect of a novel computer-assisted navigation technique for intraoperative correction of femoral rotation deformity in diaphyseal fractures.Methods From November 2015 to November 2016,a navigation system (BrainLAB,Germany) was used in antegrade intramedullary nailing for 13 patients with femoral shaft fracture to intraoperatively restore the normal length and rotation of the fractured femur.They were 11 men and 2 women,with an average age of 38.2 years.The iujury affected the left side in 5 cases and the right side in 8.According to the Winquist Classification,there were 6 cases of type Ⅰ,3 ones of type Ⅱ,3 ones of type m,and one of type Ⅳ.This navigation system allowed the surgeons to detect and set the femoral anteversion (FAV) and length of the injured leg at the desired angle and length of the healthy contralateral femur,precisely matching the contralateral limb and restoring the normal length and rotation of the fractured femur.All the patients underwent postoperative CT scan of bilateral femora for measurement of the lengths and rotations which were conpared with the intraoperative values obtained with the navigation system.Results Additional operative time required for computerized navigation averaged 42.8 min (from 35 to 55 min).The mean length difference between the treated and untreated femora was 4.2 nnn (from 2 to 9 mm).The FAVs obtained from intraoperative navigation and postoperative CT scan were 34.0° ± 8.4° and 33.5° ± 8.3° in the healthy side and 31.2° ± 8.5° and 32.8° ± 9.0° in the injured side,showing no significant differences either between the 2 sides or between intraoperation and postoperation (P ＞ 0.05).The mean rotational difference between the 2 extremities were 4.8° ± 1.6° for the navigation and 3.8° ± 1.9° for the CT scan,showing an insignificant difference (P ＞ 0.05).All the incisions healed well with no intraoperative or postoperative complications.Conclusions This novel navigation technique may serve as a reliable tool to accurately correct the rotational malalignment of femoral shaft fractures intraoperatively,but care should be taken in every step of the navigation procedure to reduce complications.

Objective To evaluate the effects of music on improving psychosomatic distress in severe patients. Methods The data were collected via China national knowledge infrastructure ( From January 1979 to December 2014), Vip journal integration platform (From January 1989 to December 2014) and Wanfang data ( From January 1982 to December 2014 ) , conducted by two researchers separately. The inclusive literatures were related to the intervention effects of music on anxiety and depression in severe patients, and the data were analyzed by Meta-analysis. The searching strategies determined by the first author; the third party would be involved into the determination in case of the divergence emerged. Results The researchers invited 11 literatures into the study and randomly compared them. Meta-analysis demonstrated that music had protective function on anxiety and the WMD(weighted mean difference)values for SAS, VAS and TAI were: -10. 13 (95%CI:-14. 56, -5. 69),-0. 73 (95%CI: -1. 21, -0. 24) and -3. 71 (95%CI: -5. 18, -2. 25);the WMD values for SDS and for UCLA were -0. 05 (95%CI: -0. 08, -0. 03) and -6. 24 (95%CI: -8. 62,-3. 87), suggested that music had protective effects on depression and on loneliness;the WMD values for sleeping time and awakening time were 1. 09 (95%CI:0. 72, 1. 45) and -0. 93 (95%CI: -1. 49,-0. 36), suggested that music could significantly increase the sleeping time and reduce the awakening time in order to cope with sleep disorder;the WMD value for blood pressure was -5. 41 (95%CI: -20. 08, 9. 27), suggested that the protective effects of music on blood pressure was uncertain;the WMD value for heart rate was -12. 35 (95%CI:-14. 68,-10. 01), suggested that music could protectively reduce the heart rate. Conclusions Music should be highly recommended for it plays a significant role in dealing with psychosomatic distress such as anxiety, depression, lonely and sleep insufficiency.

OBJECTIVETo examine the procoagulant effects of thrombolytic agent on hemostasis and study the role of hemostatic markers as predictors of clinical outcomes.

METHODSIn the present study, eighteen patients with acute myocardial infarction (AMI) received 1.5 or 2.0 million U nonspecific urokinase (UK), or 70 approximately 80 mg fibrin-specific recombinant tissue plasminogen activator (rt-PA) and did not use heparin until 8 hours after intravenous injection of the above agents. Eight patients with AMI and without thrombolytic therapy were enrolled as controls. Coagulant and thrombolytic activity markers included thrombin-antithrombin III complex (TAT), D-dimer, fibrinogen (Fg), FMPV/Amax. All markers were determined before, immediately, 1, 2, 4 and 8 hours after the administration of thrombolytic agents respectively.

RESULTSMolecular marker of thrombin generation--TAT showed an activated coagulant state immediately after thrombolytic therapy. Level of TAT showed no significant changes between every two observed phases in controls. However, level of TAT increased significantly from 4.95 +/- 1.75 microg/L ( 4.63 +/- 1.37 microg/L) to 14.71 +/- 3.31 microg/L (14.25 +/- 2.53 microg/L) before and immediately after administration of thrombolytic agents UK (or rt-PA). There was significant difference between level of serum TAT of patients with and without thrombolytic therapy (P < 0.05). Patients achieving clinical reperfusion had lower TAT level than those failing in thrombolytic therapy, and higher FMPV/Amax level than controls. D-dimer, a surrogate of thrombolytic activity increased markedly and Fg significantly declined after thrombolytic therapy (P < 0.05).

CONCLUSIONSThrombin generation occurred in plasma in response to excess fibrinolysis induced by thrombolytic therapy. Both urokinase and rt-PA had procoagulant action. This transient activation of the coagulant system might contribute to early reocclusion. These data provided the theoretical support for simultaneous administration of anticoagulant therapy with thrombolytic agents. These results also suggested that TAT might be useful in predicting clinical outcomes of patients treated with thrombolytic therapy for AMI.

Aged ; Antithrombin III ; Biomarkers ; blood ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Fibrinogen ; metabolism ; Fibrinolytic Agents ; therapeutic use ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; blood ; drug therapy ; Peptide Hydrolases ; blood ; Recombinant Proteins ; therapeutic use ; Thrombolytic Therapy ; Tissue Plasminogen Activator ; therapeutic use ; Urokinase-Type Plasminogen Activator ; therapeutic use

OBJECTIVEThe platelet membrane glycoprotein (GP) Ia/IIa plays a major part as a primary collagen receptor in platelet function. Previous studies indicated that variations of GPIa/IIa density and function are associated with the 807 C/T polymorphism of GPIa gene in American and Spanish Caucasian populations. This study investigated the correlation between acute coronary syndrome (ACS) and 807 C/T dimorphism of GPIa gene in Chinese of Han ethnicity.

METHODSA case-control study was carried out, including 75 patients with either acute myocardial infarction (AMI) or unstable angina pectoris (UAP), and 65 controls with no history of coronary heart disease, thrombogenic and hemorrhagenic diseases. Genotypes of GPIa were checked by polymerase chain reaction-sequence specific primers (PCR-SSP) technique.

RESULTSThe frequencies of both homozygotes and heterozygotes for T807 allele (TT+TC) were significantly higher in patients with AMI than in controls (62.16% vs 33.85%, P<0.01; odds ratio 3.21). The prevalence of (TT+TC) genotypes was also markedly higher in patients with UAP than in controls (65.79% vs 33.85%, P < 0.005; odds ratio 3.76). There was significant difference in the distribution of (TT+TC) genotypes not only between all patients and controls (64.00% vs 33.85%, P<0.005; odds ratio 3.47) but also between the two subgroups aged <60 years (70.00% vs 38.24%, P<0.005; odds ratio 3.77). However, there was no significant difference in the distribution of (TT+TC) genotypes between patients with AMI and with UAP. Platelet GPIa T807 allele remained significantly associated with AMI and UAP by multiple logistic regression (odds ratio 4.94).

CONCLUSIONThis study suggests a strong association between presence of GPIa T807 allele and ACS. T807 allele can be a marker of genetic susceptibility to ACS.

Aged ; Alleles ; Angina, Unstable ; genetics ; Asian Continental Ancestry Group ; Case-Control Studies ; China ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Integrin alpha2 ; genetics ; Male ; Middle Aged ; Myocardial Infarction ; genetics ; Odds Ratio ; Polymorphism, Genetic

Human-like collagen (HLC) was cross-linked with hyaluronic acid by genipin in different ratio. The concentrations of hyaluronic acid in the mixture were 0, 0.01%, 0.05% and 0.1%. The blood vessel tubular grafts were then fabricated by freeze-drying. Microstructure, element composite, mechanical properties, cytotoxicity grade, and biocompatibility of different vascular scaffold groups were studied by scanning electron microscope (SEM), X-ray photoelectron spectroscopy (XPS), tensile test, burst pressure experiment, cytotoxicity experiment, endothelial cells planted in blood vessel scaffolds and hypodermic embedding of mice. The results showed that HLC-HA (0.05%) tubular scaffold exhibited interconnected well-distributed and porous structure and porosity of 94.38%; achieved the desirable mechanical property with stress of (1000.8 +/- 7.9) kPa and burst pressure of (1058.6 +/- 8.2) kPa, hypocytotoxicity, favourable cytocompatibility, hisocompatibility and disposition of degradation.
Adhesives ; chemistry ; Animals ; Biocompatible Materials ; chemistry ; Biomimetic Materials ; chemistry ; Blood Vessels ; drug effects ; physiology ; Collagen ; chemistry ; Humans ; Hyaluronic Acid ; chemistry ; Iridoid Glycosides ; Iridoids ; chemistry ; Materials Testing ; Mice ; Tissue Engineering ; instrumentation ; methods ; Tissue Scaffolds

Objective To study the prognostic role of plasma neutrophil gelatinase-associated lipocalin (NGAL) early after renal transplantation.Methods A total of 37 kidney recipients were enrolled from Department of Organ Transplantation,Guangdong Second Provincial General Hospital within a 12-month period of time.Plasma NGAL was measured immediately before and at 6 and 12 h post-transplantation.Changes of serum creatinine were documented daily within the first week postoperation.Acute kidney injury (AKI)/graft rejection during the first week after transplantation was the outcome variable.Results The levels of serum NGAL in the 37 patients were (311.14 ± 102.69),(317.81 ± 107.28) and (312.16 ± 134.80) μg/L respectively immediately before and at 6 and 12 h post-transplantation.There was no significant difference in serum NGAL levels before and 6 h or 12 h after operation (P =0.70,and P =0.96).There were no significant differences in gender and age between the two groups (P =0.29,and P =0.20).There was significant difference in creatinine levels between the AKI group and the non-AKI group (P =0.002) and between pre-operation and 6 or 12 h postoperation.The preoperative levels of serum NGAL in AKI group and non-AKI group were (333.58 ± 116.30) and (300.36 ± 96.15) μg/L (P =0.36),and those were (383.3 ± 147.16) and (286.32 ± 65.97) μg/L (P＜0.01) at 6 h,and (437.33 ± 164.16) and (252.08 ± 57.53) μg/L (P＜ 0.001) at 12 h after operation.The sensitivity and specificity of serumNGAL (317μg/L at 12 h after operation as the cutoff value) predicting AKI was 100％ and 92％ respectively,which was much better than that of serum creatinine at the corresponding time point (sensitivity =66.7％,and specificity =61.9％).Conclusion Plasma NGAL,particularly at 12 h after transplantation,is a very sensitive and specific biomarker for predicting AKI.

OBJECTIVETo investigate the MEK and ERK expression and their relationship with clinicopathological parameters in human breast carcinoma, and the effect of preoperative chemotherapy on MEK and ERK protein expression.

METHODSSamples were obtained from 56 patients with breast carcinoma and 8 patients with benign tumors. Sixteen of the 56 patients received preoperative chemotherapy. Western blot and immunohistochemistry were used to measure the expression of MEK1, MEK2 and ERK1, ERK2 protein.

RESULTSMEK2 and ERK1, ERK2 protein levels were increased in breast carcinoma tissue compared with those in adjacent normal tissues (t = 7.244, 5.959, 3.735, P < 0.01) and benign tumors (t = 2.206, P < 0.05). The levels of MEK1 were decreased. The expression of MEK2 protein in ER negative patients was higher than that in ER positive ones. MEK2 protein levels were lower in patients who received preoperative chemotherapy than in those who did not.

CONCLUSIONOverexpression of MEK-ERK may play an important role in the development of human breast carcinoma. MEK and ERK protein expressions are inhibited by preoperative chemotherapy.

Adult ; Aged ; Blotting, Western ; Breast Neoplasms ; diagnosis ; enzymology ; metabolism ; Female ; Humans ; Immunohistochemistry ; MAP Kinase Kinase 1 ; MAP Kinase Kinase 2 ; MAP Kinase Signaling System ; physiology ; Middle Aged ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; Mitogen-Activated Protein Kinase Kinases ; metabolism ; Mitogen-Activated Protein Kinases ; metabolism ; Prognosis ; Protein Kinases ; metabolism ; Protein-Serine-Threonine Kinases ; metabolism ; Protein-Tyrosine Kinases ; metabolism

Objective To evaluate the targeted surveillance of health care-associated infections in ICU. Methods PubMed, EMBASE ( Excerpt Medica Database ) , China Biology Medicine disc, China National Knowledge Infrastructure, Vip Journal Integration Platform and Wanfang Data were searched from 2009 to 2013 by two researchers. Full-text studies on targeted surveillance of healthcare-associated infections in ICUs were included. Studies were evacuated using STROBE and GRADE. Random effects meta-analyses were used to generate summary estimates of infection rates. Results Totals of 21 studies met eligibility criteria, which were all Chinese research papers. Taking the infection rate as an example, 74 600 cases were observed within which 7 318 cases were infected. Pooled meta-analyses of eligible studies revealed that adjusted infection rate:infection rate, case infection rate, daily infection rate, case daily infection rate were 3. 27%, 4. 92%, 4. 58‰, 6. 49‰, respectively. The infection rates were 23. 12‰ in ventilator associated pneumonia, 5. 26‰ in catheter-related bloodstream infections, and 2. 38‰ in catheter-associated urinary tract infections. The lower respiratory tract, the blood, and the urinary tract were the main infection sites, accounting for 58. 07%, 18. 16%, and 15. 35%, respectively. A. baumanii, P. Aeruginosa, fungi, S. aureus, K. pneumoniae, E. coli were the main pathogens, accounting for 20. 54%, 14. 28%, 14. 35%, 11. 62%, 10. 92% and 6. 86%, respectively. Conclusions The burden of health-care-associated infection in ICU is high. Our findings indicate a need to improve surveillance and infection-control practices.