Clinicians monitor the gastric residual volume(GRV) of critical ill patients to minimize or prevent side effect of EN.Nevertheless,recommendations about the threshold GRV in critically ill patients treated with EN are not uniform.Many recent clinical studies had demonstrated that increasing the limit of GRV was associated with the increase in the diet volume ratio of ICU patients receiving EN,and it was not associated with adverse effects in gastrointestinal complications.This review summarizes the influence factors of GRV monitoring to evaluate the feasibility and necessity of increasing the threshold of GRV.

Objective To establish a novel model of senile dementia in rats. Methods Fifty-two Wistar male rats were divided into 5 groups, group A was treated with a permanent bilateral occlusion of both carotid arteries (2-VO) first and then intraperitoneal injection of D-galactose (60 mg?kg -1 ?d -1 ,ip,42 d), group B with intraperitoneal injection of D-galactose (60 mg?kg -1 ?d -1 ,ip,42 d) first and then permanent bilateral occlusion of both carotid arteries, group C with 2-VO, group D with intraperitoneal injection of D-galactose, and group E (normal control) without the above treatment. All the rats were tested by using Morris water maze for their performance in learning and memory. Results Wistar rats treated with both 2-VO and D-galactose presented a significant diffe-rence from those simply treated by 2-VO and the normal rats. Conclusion The rat model of senile dementia induced by 2-VO and D-galactose simulated some characteristics of human senile dementia, and might be used in basic experiment study of senile dementia, such as vascular dementia, Alzheimer′s disease and mixed dementia.

To determine the lysis spectrum of Yersinia enterocolitica bacteriophage phiYe-F10 and to analyze the relationship between the lysis ability of phiYe-F10 and the virulence gene of Yersinia enterocolitica. To observe the lysis ability of the phage phiYe-F10 to the different Yersinia strains with the double-layer technique. The strains used in this study including 213 of Yersinia enterocolitica and 36 of Yersinia pseudotuberculosis and 1 of Yersinia pestis. The virulence genes of these Yersinia enterocolitica (attachment invasion locus (ail) and enterotoxin (ystA, ystB) and yersinia adhesin A (yadA), virulence factor (virF), specific gene for lipopolysaccharide O-side chain of serotype O : 3 (rfbc) were all detected. Among the 213 Yersinia enterocolitica, 84 strains were O : 3 serotype (78 strains with rfbc gene), 10 were serotype O : 5, 13 were serotype O : 8, 34 were serotype O : 9 and 72 were other serotypes. Of these, 77 were typical pathogenic Yersinia enterocolitica harboring with virulence plasmid (ail+, ystA+, ystB-, yadA+, virF+), and 15 were pathogenic bacterial strains deficiency virulence plasmid (ail+, ystA+, ystB-, yadA-, virF-) and the rest 121 were non pathogenic genotype strains. PhiYe-F10 lysed the 71 serotype O : 3 Yersinia enterocolitica strains which were all carried with rfbc+, including 52 pathogenic Yersinia enterocolitica, 19 nonpathogenic Y. enterocolitica. The phiYe-F10 can not lysed serotype O : 5, O : 9 and other serotype Y. enterocolitica, the lysis rate of serotype O : 3 was as high as 84.5%. The phiYe-F10 can not lysed Yersinia pseudotuberculosis and Yersinia pestis. Yersinia phage phiYe-F10 is highly specific for serotype O : 3 Yersinia enterocolitic at 25 degrees C, which showed a typical narrow lysis spectrum. Phage phiYe-F10 can lysed much more pathogenic Y. enterocolitica than nonpathogenic Y. enterocolitica.
Bacterial Proteins ; genetics ; metabolism ; Bacteriophages ; genetics ; isolation & purification ; physiology ; Host Specificity ; Virulence Factors ; genetics ; metabolism ; Yersinia enterocolitica ; genetics ; metabolism ; virology

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 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.

Objective To investigate the relationship between oxidative stress and lipid metabolism characteristics in elderly patients under different status of thyroid function. Methods Eighty-six newly-diagnosed elderly patients with thyroid diseases,83 non-elderly patients with thyroid diseases and 20 normal subjects as control were selected.and 47 hyperthyroidism and 39hypothyroidism in elderly,43 hyperthyroidism and 40 hypothyroidism in non-elderly were diagnosed according to diagnostic criteria of the thyroid disease.The levels of fasting plasma malondialdehyde(MDA),superoxide(SOD)and oxidized low density lipoprotein(OX-LDL)were measured by thiobarhiturates,colorimetric method and enzyme linked immunosorbent assay(ELISA).Meanwhile,lipid profile and thyroid function were also measured,SOD/MDA ratio was calculated. Results Lipid profiles in the elderly hyperthyroidism group were significantly higher than those in the non-elderly group(P＜O.05 or P＜0.01)but were significantly lower than those of normal control group(P＜0.05 or P＜0.01).The plasma MDA[(10.23±6.29)μmol/L vs.(3.66±2.53)μmol/L vs.(7.37±4.58)μmol/L],free fatty acids(FFA)[(0.86±0.58)mmol/L us.(0.45±0.12)mmol/L vs.(0.61±O.46)mmol/L]and SOD levels were significantly higher in elderly patients with hyperthyroidism than in normal control and non-elderly hyperthyroidism groups(P＜0.05 or P＜O.01).In the patients with hypothyroidism,the plasma MDA[(9.03±5.98)μmol/L vs.(6.59±3.18)μmol/L vs.(3.66±2.53)μmol/L],OX-LDL[(387.36±71.04)μg/L vs.(355.22±45.01)μg/L vs.(324.53±56.19)μg/L],TC,LDL-C,non-HDL-C,LP(a) and Apo-B100 levels were significantly higher in the elderly group than in the non-elderly and normal control groups(P＜0.05 orP＜0.01).The SOD/MDA ratio was significantly lower in the elderly patient groups with hyperthyroidism or hypothyroidism than in normal control and non-elderly groups(all P＜0.01).In a multiple step-wise regression analysis.FT4 and FFA were independent factors related tO MDA in hyperthyroidism group,and non-HDL-C and LDL-C were independent factors related to MDA inhypothyroidism group. Conclusions Serious lipid metabolic disorder exists in newly-diagnosed and untreated elderly patients with hyperthyroidism and hypothyroidism.It is suggested that oxidative stress is obviously strengthened in elderly patients with thyroid function disorder and that the degree of oxidative stress is correlated with lipid metabolic disorder.

Objective To investigate the mechanism of BVT. 2733 on insulin resistance, by using diet-induced obese (DIO) mice model. Methods After having been balanced for 3 days, the C57BL/6J mice were randomly divided into a normal diet group and a high-fat diet (HFD) group. After 20 weeks, the obese mice were further randomly divided into an obese control group, a BVT. 2733 group and a pioglltazone (PGZ) group and they were orally administered with placebo, BVT. 2733 and PGZ separately for two weeks.Adiponectin and leptin mRNA expression levels from adipose tissue were analyzed with real-time quantitative PCR. The levels of plasma glucose, serum insulin and adiponectin were measured with biochemical technology, radioimmunoassay and ELISA. Adipocyte sizes were observed with immunohistocbemistry.Results The body weight, plasma glucose and serum insulin levels raised(P<0.05)in the HFD group and the adipocyte sizes were bigger. Serum insulin levels significantly reduced (P<0.05) and adipocyte sizes reduced, while plasma adiponectin level raised (P<0.01)in the two treatment groups as compared with those in obese controls. Both the mRNA expressions of adiponectin and leptin upregulated(P<0.05)in the PGZ group, but their expressions in the BVT. 2733 group did not alter significantly. The body weight of the mice reduced significantly in the BVT. 2733 group. Conclusion BVT. 2733 can reduce body weight significantly and improve insulin resistance, but cannot influence the expression of adipocytokines.

Objective To investigate the clinical and immunological features,therapeutic response as well as prognosis of adult onset Still's disease (AOSD).Methods AOSD was diagnosed in 137 patients referred to our department.Clinical and immunological data were retrospectively analyzed.Therapeutic response and prognosis were systemically reviewed during the follow-up period.Intergroup incidence divergence was analyzed by chi-square test.Cox regression analysis was adopted to determine factors related with relapse.Results Fever,rash and arthritis were the cardinal clinical features of AOSD patients.Elevated inflammatory indices including ferritin (128 suhjects,97.1％ ) along with neutrophilia and liver dysfunction were the main laboratory findings.Ninety-eight patients were followed up and 75％ (73 subjects) had achieved complete remission after 4 weeks treatment.Forty-one patients (42％) who had achieved remission relapsed during follow-up period.Combination of glucocorticoid steroid and disease modifying antirheumatic drugs (DMARDs) were more effective than glucocorticoid steroid only in inducing remission and preventing relapse.More patients received glucocorticoid combined with methotrcxate and hydroxychloroquine achieved remission (8 of 8 patients) than patients who were treated with glucocorticoid and methotrexate (25 of 28 patients,89％ ) and those treated with glucocorticoid and hydroxychloroquine (14 of 16 patients,88％ ).Patients with glucocorticoid were more likely to suffer disease recurrence than those who took glucocorticoid combined with DMARDs (61％ vs 29％,P=0.004).Cox regression analysis suggested that methotrexate had protec-tive effect against recurrence [RR=0.418,95％CI (0.192-0.909),P=0.028].5％ of patients were diagnosed to other diseases during the follow up period.Conclusion Initial treatment with combined glucocorticoid and DMARDs is beneficial to induce remission and prevent reoccurrence.Methotrcxate has a protective effect against recurrence.

Objective To investigate the number and activities changes of peripheral blood endothelial progenitor cells (EPCs) in continuous ambulatory peritoneal dialysis (CAPD) patients,and explore the connection between EPCs' number and the levels of advanced glycosylation end products (AGEs),homocysteine (Hcy) and C-reactive protein (CRP).Methods Twenty-five CAPD patients and thirty healthy volunteers were involved.Total mononuclear cells (MNCs) were isolated from peripheral blood of patients.EPCs were characterized as adherent cells by double staining of FITCUEA-1 and DiL-AcLDL binding,and were further demonstrated by positive cells of CD34,CD133 and KDR using flow cytometry.The abilities of cell proliferation,adhesion and migration were further observed by fluorescent microscope.The correlations between the CEPCs' number and the levels of AGEs,Hcy and CRP were analyzed.Results The number and activities including migration and adhesion of EPCs in CAPD group were significantly lower than control group (P ＜ 0.05).The levels of serum AGEs,Hey and CRP in CAPD patients were increased (all P＜0.05) and had negative correlation with EPCs' number.Conclusions The number and activities of EPCs decrease in patients with CAPD,and EPCs' number is negatively correlated to the levels of AGEs,Hcy and CRP.

Objective To investigate the influence of thymosin beta 4 (Tβ4) with two different dosages on the expression of transforming growth factor beta (TGF-β) and connective tissue growth factor (CTGF) in rats with renal tubular interstitial fibrosis,and to further estimate the changes of renal tubular interstitial lesions.Methods Rat models of renal tubular interstitial fibrosis were established by unilateral ureteral occlusion (UUO).The male SD rats were randomly divided into 4 groups and 15 rats in each group:sham group,model group,treatment group with 1 mg/L Tβ4 and treatment group with 5 mg/L T34.Rats in sham group and model group were poured into the same amount of saline.The renal function and renal pathological changes were observed after the second week.The mRNA and protein expression of TGF-β and CTGF in renal tissues was tested by in-situ hybridization and Western blotting.Results Compared with that in sham group,the expression of TGF-β mRNA and its protein,CTGF mRNA and its protein was significantly higher in model group (all P ＜ 0.01).Compared with rats of model group,Tβ4 treatment rats had lower mRNA and protein expression of TGF-β and CTGF (all P ＜ 0.01),and the expression in treatment group with 5 mg/L Tβ4 was lower than that in treatment group with 1 mg/L Tβ4 (P ＜ 0.05).And the expression of TGF-β mRNA was positively correlated with CTGF mRNA expression (r=0.697,P ＜ 0.01).The 24 h total urinary protein and the area of renal tubular interstitial lesion in model group were significantly more than those in sham group,and also more than those in Tβ4 treatment group (all P ＜ 0.05).Tβ4 treatment attenuated kidney damage,and the effects in treatment group with 5 mg/L Tβ4 were better than those in treatment group with 1 mg/L Tβ4.No difference in serum creatinine and blood urea nitrogen was observed among 4 groups (all P ＞ 0.05).Conclusions Tβ4 treatment can inhibit the renal TGF-β and CTGF expression of rats with tubular interstitial fibrosis in a dose-dependent manner,and play a protective role in kidney.