Objective To explore nursing points on the enteral nutrition support to batched patients with severe burn caused by explosion. Method An enteral nutrition support was carried out for 15 patients with severe burns admitted in our department and pertinent nursing was performed. Results Five patients died because of lack of autologous skin sources and complications of sepsis in 45~87 d after burn. Ten patients got a good recovery after enteral nutrition support, anti-infection treatment and nursing. They lived through the infection period, went into the recovery period. The hospital stay of these patients in ICU was 54~115 d with an average of (90.63 ± 30.37)d. Conclusion Early enteral nutrition support and nursing to the patients with severe burn can improve the nutritional status of patients effectively and promote the rehabilitation of patients.

Objective To investigate the effects of ischemic preconditioning (IP) on blood-brain barrier permeability and matrix metalloproteinase-9 expression after cerebral ischemia reperfusion in rats.Methods A total of 154 Wistar rats were randomly divided into sham operation (n = 14),non-ischemic preconditioning (NIP,n = 70),and IP (n = 70) group.The latter two groups were redivided into 5 subgroups (n = 14 in each subgroup).A middle cerebral artery occlusion model was induced by intraluminal suture method.After 10 minutes IP,re-ischemia for 2 hours and reperfusion for 22 hours were performed at day 1,3,7,14,and 21,respectively.The infarct volume was detected using 2,3,5-triphenyltetrazolium chloride (TTC)staining.The BBB permeability were evaluated by measuring the content of the extravascular exudation of Evan's blue (EB).The degree of cerebral edema was evaluated using the wet-dry weight method.MMP-9 protein and mRNA expression were detected by immunohistochemical staining and in situ hybridization.Results Compared to the corresponding subgroups in the NIP group,the neurological deficit scores,infarct volume,EB content,and brain water content were decreased significantly,and MMP-9 protein and mRNA expression were down-regulated significantly in the day 1,3,and 7 subgroups in the IP group (P ＜ 0.05 or P ＜ 0.01 ).The infarct volume and MMP-9 mRNA expression of the day 1,3,7 subgroups in the IP group were more significantly reduced or down-regulated than those of the day 14 and21 subgroups in the IP group.The EB content,brain water content,and MMP-9 protein expression of the day 3 and 7 subgroups were more significantly lower than those in other subgroups.Among them,they were decreased most significantly in the day 3 subgroup (P ＜ 0.05).Conclusions The changes of IP-induced BBB permeability and the down-regulated MMP-9 expression may play important roles in cerebral ischemic tolerance.

BACKGROUND: After tooth extraction, residual ridge resorption is a complicate process, while stress is one of the main causes. Recent studies have demonstrated that osteopontin (OPN) is a kind of agent that is sensitive to mechanical stress.OBJECTIVE: To study the role of OPN in mediating mechanical stress effect on bone, and to investigate the relationship of OPN and bone rebuilding, action mechanism of OPN and cell surface receptor and the relationship of OPN and osteoblast and osteoclast, in order to reveal the molecule mechanism of residual ridge resorption mainly caused by stress, and also to be a basic theory for clinical molecule therapy or gene therapy.RETRIEVE STRATEGY: PubMed was searched from January 1985 to June 2007 for English literatures with the searching words of "OPN, mechanical stress and bone resorption" and China Journal Full-text Database was also searched from January 1995 to June 2007 for Chinese literatures with the searching words of "OFN, mechanical stress and bone resorption". Fifty-two literatures were retrieved. The data were primarily selected. Inclusive criteria: being relative to role of OPN in mediating mechanical stress effect on bone. Exclusive criteria: repetitive studies.LITERATURE EVALUATION: Among the 52 literatures, including 6 Chinese and 46 English, 5 were rejected for objective independent from this study, 13 for repetitive contents, and so 34 literatures were involved for further analysis on the role of OPN in mediating mechanical stress effect on bone, 6 being review and the others being clinical or basic studies.DATA SYNTHESIS: ①After tooth extraction, residual ridge resorption is a complicate process. It also influences the effect of artificial denture, while stress is the main cause. ② OPN is widely distributed throughout the body, and has many physiologic functions. Recent studies have demonstrated that OPN is a kind of agent that is sensitive to mechanical stress. ③Bone is a special kind of biological tissue, bone resorption and bone rebuilding both can take place when it is lack of mechanical stress (atrophy of disuse),or endures mechanical stress. ④Bone rebuilding can be seen as the results of these molecule events. OPN, as a main protein, participates in the bone resorption and bone rebuilding. ⑤These OPN can be seen as a chemotatic factor to guide prosoma osteoclast to migrate to the surface of the bone, and mediate it to combine with the integrin on the surface of osteoclast so to promote the resorption of bone. So, OPN is a necessary factor in mechanical stress induced bone loss. ⑥OPN is a signal of transmission between osteoblast and osteoclast. ⑦OPN can be seen as a long acting feedback inhibition signal to inhibit bone mineralization.CONCLUSION: OPN is a kind of agent that is sensitive to mechanical stress. It plays an important role in mediating mechanical stress effect on bone.

Bacteremia is a common complication in patients with liver cirrhosis,and its incidence rises as the severity of liver disease increa-ses.Liver cirrhosis complicated by bacteremia will lead to poor prognosis.The research progress in liver cirrhosis complicated by bacteremia is reviewed from the following aspects:risk factors,diagnostic points,treatment methods,prevention,and prognosis.It is believed that ear-ly prevention and treatment of bacteremia have great significance for the prognosis of patients with liver cirrhosis.

Objective To evaluate the effectiveness and safety of interventional embolectomy in the treatment of acute massive pulmonary embolism. Methods Interventional managements, including fragmentation, aspiration and dissolving of the embolus, were performed in 12 patients with CTPA-or pulmonary angiography-proved acute massive pulmonary embolism. Clinical manifestations, blood gas tension, hemodynamic changes, the recanalization of the pulmonary artery as well as the occurrence of complications were observed. Results Eleven patients survived and nine patients showed significant clinical improvement. PaO2 was increased from (54.92 ? 6.17)mmHg before the procedure to (90.91 ? 1.62)mmHg after the procedure (P = 0.001), and SaO2 was also increased from (85.17 ? 8.39)mmHg before the procedure to (95.75 ? 1.96)mmHg after the procedure (P = 0.001). Miller score (21.75 ? 4.35 vs 13.83 ? 5.69, P = 0.001) and mPAP (25.59 ? 7.68 mmHg vs 30.04 ? 7.93 mmHg, P = 0.001)decreased significantly. One patient died of pulmonary embolism and one died of intracerebral bleeding three days after the procedure. Conclusion Interventional embolectomy is an effective and safe technique for the treatment of acute massive pulmonary embolism.

BACKGROUND:Treatment programs for low back pain are of great varieties, but there is stil no a definite treatment. Pressure biofeedback instrument is a tool to measure abdominal muscle activity, and its reliability in the treatment of low back pain is less reported. OBJECTIVE:To explore the reliability and feasibility of the pressure biofeedback instrument for assessment of low back pain. METHODS:Thirty patients with chronic low back pain were enrol ed and subject to four kinds of postures:posture A was prone position;posture B was supine position with flexion of the knee joints, posture C was supine position with unilateral flexion of the hip and knee joint, posture D was prone position with unilateral shoulder flexion. Intra-abdominal pressure values under the different postures were measured twice within a week in the same subject. Intraclass correlation coefficient (ICC) was used to assess the reliability. RESULTS AND CONCLUSION:Posture A had good test-retest reliability, and the value of ICC was 0.853 (95%confidence interval:0.691-0.930);posture B showed moderate test-retest reliability, and the ICC value was 0.751 (95%confidence interval:0.477-0.882);posture C also had moderate test-retest reliability, and the ICC value was 0.789 (95%confidence interval:0.557-0.900), posture D had good test-retest reliability, and the value of ICC was 0.892 (95%confidence interval:0.641-0.919). Therefore, the pressure biofeedback for evaluation of low back pain has good reliability, which can be used for the evaluation of low back pain.

Objective:To evaluate the effects of several kinds of surface treatment methods on the bond strength of zirconia prosthesis,and to provide references for improving the bond strength of zirconia prosthesis.Methods:Sixty zirconia blocks(10 mm×10 mm×2 mm) were divided into 6 groups according to the surface treatment methods:sandblasting,silica coating,Z-PRIME Plus,sandblasting+Z-PRIME Plus,sandblasting+silica coating,and silica coating+Z-PRIME Plus groups.The zirconia-resin specimens were fabricated using ScotchbondTM Universal;shear bond test was performed to detect the shear bond strength after treated with water storage(37℃) for 24 h by universal mechanical testing mechine;the fracture types were observed by stereoscopic microscope.One fracture specimen was randomly chosen from each group,and the morphology of the specimen was examined under scanning electron microscope.Results:The shear bond strength of the specimen in Z-PRIME Plus group was higher than those in the other groups(P<0.05).The adhesive failure was predominantly observed in sandblasting,silica coating,sandblasting+silica coating and silica coating+Z-PRIME Plus groups.There were 4 cases of mixed failure in Z-PRIME Plus group and there were 8 cases of mixed failure in sandblasting+Z-PRIME group.No cohesive failure was observed in all the groups.The scanning electron microscope results showed that the fracture surface occurred on the resin-zirconia interface of the specimens in sandblasting group,Z-PRIME Plus group,and sandblasting+Z-PRIME Plus group.The silica-zirconia fracture of specimens occurred in silica coating group and silica coating+Z-PRIME Plus group.The silica-resin interface fracture of specimens partially occurred in sandblasting+silica coating group.Conclusion:The application of Z-PRIME Plus can significantly improve the bond strength between zirconia and resin.

BACKGROUND:Studies have confirmed that the active ingredients ofPaeonia lactiflora Pal. have better inhibitory effects onCandida albicans, but its monomer paeoniflorin has not been reported whether it can inhibit Candida albicans biofilm. OBJECTIVE:To observe the effect of paeoniflorin onCandida albicans biofilm in vitro. METHODS:Paeoniflorin solution at different concentrations of 4, 2, 1, 0.5, 0.25 g/L was prepared using RPMI-1640 according to 2-fold dilution method. Chlorhexidine was diluted with RPMI-1640 to different concentrations, including 2%, 1%, 0.5%, 0.25%, 0.125%. We compared the effects of different concentrations of chlorhexidine and paeoniflorin on diameter ofCandida albicans by agar diffusion method. MTT assay was used to detect the effect of different concentrations of chlorhexidine or paeoniflorin on the celladhesion of Candida albicans as wel as their inhibitory effects onCandida albicans biofilms. Confocal laser scanning microscope and LIVE/DEAD BacLight Bacterial Viability Kits were combined to observe the changes ofCandida albicans biofilms under normal or intervention conditions. RESULTS AND CONCLUSION:Both chlorhexidine and paeoniflorin possessed bacteriostatic ability, and their bacteriostatic ring diameters were positively correlated with drug concentrations. Significant differences in the bacteriostatic ring diameter were observed between chlorhexidine and paeoniflorin, except between 2 g/L paeoniflorin and 1%, 2% chlorhexidine. Paeoniflorin at different concentration could inhibit celladhesion of Candida albicans as wel as inhibitCandida albicans biofilm. The inhibition rate was also positively correlated with drug concentrations. Under normal conditions, most of bacteria in the biofilms were alive, and there was a smal amount of dead bacteria after 48 hours. After intervention with paeoniflorin, the proportion of dead bacteria in the biofilms was increasing along with the concentrations of paeoniflorin. Compared with the chlorhexidine, paeoniflorin showed a lower bacteriostatic activity. These findings indicate that paeoniflorin has an obvious inhibitory action in Candida albicans biofilms in vitro.

BACKGROUND: Most of anti-osteoporosis drugs can only inhibit bone resorption, but can not improve the bone formation. So far, Strontium ranelate is the only anti-osteoporosis drug that has a dual effect on bone resorption and bone formation. Through the retrieval of related studies, the present review article evaluates the current understanding of strontium ranelate effects on bone resorption based on the pharmacologic experiments, clinical studies, action mechanisms. Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used on clinic; however, there are still few reports addressing rhBMP-2-induced osteogenesis in intervertebral disc.

Objective To investigate the association of vascular calcification,fetuin A and Creaction protein (CRP),and explore the influence on cardiovascular events.Methods Sixty peritoneal dialysis (PD) patients were enrolled in this study.Carotid intima-media thickness (cIMT),fetuin A and CRP,along with the other serum related parameters were detected to find out their influence on vascular calcification in PD patients.The relationship between cIMT,fetuin A,CPR and cardiovascular events was analyzed in PD patients with 18 months followed-up.Results Of the 60 PD patients,carotid intima-media thickness (cIMT) was increased in 38 patients(63.3％).Compared with the non-increased cIMT patients,serum fetuin A concentration was significantly decreased(P ＜ 0.05),CRP(P＜0.01) and calcium × phosphate products(P＜0.05) were significantly increased in the highincreased cIMT group.Compared with the low-increased cIMT patients,fetuin A concentration was obviously lower(P ＜ 0.05) and calcium×phosphate products were obviously higher(P ＜ 0.05) in the highincreased cIMT group.Linear regression analysis discovered an obvious negative correlation between CRP and fetuin A(R2 =0.629,F=47.522,P ＜ 0.01),as well as fetuin A and calcium×phosphate products (R2=0.299,F=11.948,P=0.002).Multiple regression analysis indicated that fetuin A was independently negatively correlated with cIMT(B=-0.019,t =-6.042,P ＜ 0.01).At 18 months,there were 36 newly-happened cardiovascular events and among which 6 cases died.Logistic regression analysis found that increased cIMT was risk factor to cardiovascular events in PD patients(OR=3.691,95％CI 1.467-9.258,P=0.006).Conclusion Decreased fetuin A and increased calcium×phosphate products deteriorate carotid calcification in PD patients.Micro-inflammation of PD patients represented by high CRP levels may increase calcium×phosphate products by depressing the fetuin A level,and in the end will stimulate carotid calcification.Increased cIMT is a risk factor for cardiovascular events.