Esophageal and Gastric Varices ; diagnosis ; etiology ; pathology ; Hemorrhage ; Humans ; Liver Cirrhosis ; complications ; pathology

Objective To study the effect of toothbrushing for ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods We searched Cochrane library,Pubmed,Embase,CBM,CNKI and Wanfang data.All searches were updated on April 30,2013.We also performed a manual search of the RCTs of toothbrushing for VAP.At least two reviewers independently screened the studies for eligibility,evaluated the quality,and extracted the data from the eligible literatures,with a cross-check to confirm accuracy.Different views were settled by a third party.The data had Meta-analysis by software Revman 5.0,and to those data which could not be conversed or merged,they underwent descriptive analysis.Results We identified 8 randomized clinical trials that met the inclusion.In Meta-analysis,the overall risk ratio for ventilator-associated pneumonia was decreased significantly by toothbrushing.Toothbrushing also improved the condition of oral odor and oral ulcer.But no significant differences were observed between two groups in hospital ICU mortality.Conclusions Compared the common oral care,toothbrushing can significantly decrease the overall risk ratio for ventilator-associated pneumonia,and improve the condition of oral odor,plaque index score and oral ulcer.

Objective To explore the effects of taurine-zinc(TZC) on blood lead content and blood-brain barrier(BBB) permeability of growing rats exposed to lead.Methods Male SD rats aged 3 weeks were randomly divided into four groups(8 in each group):control group,lead exposure group,dimercaptosuccinic acid(DMSA) group and TZC group.The exposure group treated with 0.12% lead acetate(0.2 ml/100 g body weight) by intraperitoneal injection,DMSA group and TZC group were treated with the same dose of lead acetate but were respectively supplemented with 5 mg/ml DMSA(2 ml/100 g body weight) by ig and 0.46 g/L TZC solution through drinking.Three weeks later,blood lead content was measured by atomic absorption spectroscopy(AAS) and changes of BBB permeability were observed using lanthanum nitrate tracer method.Results Compared with the lead exposure group,the blood lead level in TZC group and DMSA group was significantly reduced(P

Objective To study CTLA4Ig gene expressed in dermal papilla cells and to provide evidence for immune tolerance after dermal papilla cells transplantation. Methods CTLA4Ig cDNA was transferred into dermal papilla cells by recombinant adenovirus vector, and the dermal papilla cells containing CTLA4Ig gene were transplanted into mice skin. The target gene expression was detected by histological and immunohistochemistry technique. Results CTLA4Ig protein was expressed in plasma 6 hours after gene transfection and increased gradually. When the transferred papilla cells were transplanted into mice skin the gene began to express in 24 hours and lasted for 2 weeks. No rejection was observed. Conclusion Dermal papilla cells containing CTLA4Ig gene can survive in vitro and in vivo and express CTLA4Ig for a long time.

Objective To explore the effects of drugs on functions of mitochondria in retinal nerve cells, and to lay a foundation of the investigation of drug protection for retinal nerve cells. Methods Cultivation of the retinal nerve cells of 8 eyes of neonatal calves was performed. The changes of fluorescent density of the mitochondria of cultured cells labeled by dye rhodamine 123 (Rh123) before and after the activation of the medicines, including ferulic acid (FA), arginine, glycine, taurine, vitamine E and brain-derived neurotrophic factor (BDNF) respectively, were detected by laser-scanning confocal microscopy. Results FA with the concentration of 500 ?g/ml led the diphasic variation of the fluorescent intensity of mitochondria. After scanning for 60.772 seconds when treated with FA firstly, the fluorescent intensity decreased rapidly (from 45.425?4.153 to 22.135?5.293); while after 112.774 seconds when treated secondly, the intensity increased obviously (from 19.655?4.383 to 28.247?4.764), and after 168.773 seconds when treated thirdly the intensity still increased. After scanning for 56.457 seconds when treated with vitamin E (12.5 mg/ml), the fluorescent intensity increased obviously (from 88.255?5.039 to 111.273?4.529), which suggested that vitamin E with the concentration of 12.5 mg/ml strengthen the fluorescent intensity. After scanning for 58.147 and 134.148 seconds when treated with BDNF (50 ng/ml) respectively, the fluorescent intensity increased obviously (from 69.115?5.038 to 77.225?5.131) which suggested that BDNF with the concentration of 50 ng/ml led the increase of the fluorescent intensity. Glycine (2.5 mg/ml) and arginine(30 mg/ml) didn't affect the fluorescent intensity of mitochondria, and taurine (6.25 mg/ml) caused the appreciable decrease of the fluorescent intensity. Conclusion FA, BDNF and vitamin E may promote the metabolism of retinal nerve cells via the path of mitochondria, while amino acids may adjust the activation of retinal nerve cells through other ways.

Objective To investigate the effect of chronic atrial fibrillation on free calcium concentration and expression of Ca 2+ /calmodulin dependent protein kinase Ⅱ (CaMKⅡ) in human atrial myocytes. Methods The intracellular free calcium concentration in rapidly isolated atrial myocytes and the expression of CaMKⅡ in atrial tissue of rheumatic heart disease patients with atrial fibrillation (AF) or with normal sinus rhythm were measured by laser scanning confocal microscopy and Western blotting respectively. Results The intracellular Ca 2+ concentration of patients with atrial fibrillation was significantly higher than that of patients with normal sinus rhythm [(276.38?38.12) vs (122.28?45.63) nmol/L, (P

AIM: To investigate the effect of chronic atrial fibrillation (AF) on free calcium concentration and expression of Ca 2+ /calmodulin dependent protein kinase Ⅱ (CaMKⅡ) in human atrial myocytes. METHODS: The intracellular free calcium concentration in acute isolated atrial myocytes and the expression of CaMKⅡ in atrial tissue of rheumatic heart disease patients with atrial fibrillation (AF) and with normal sinus rhythm were measured by laser scanning cofocal microscopy technique and Western blotting, respectively. RESULTS: The intracellular Ca 2+ concentration in patients with atrial fibrillation was significantly higher than that in patients with normal sinus rhythm [(276.38?38.12) nmol/L vs (122.28?45.63) nmol/L, P

Objective To determine the effects of dose reduction on multi-slice spiral CT(MSCT) of neonatal head and assess the lowest possible radiation for acceptable clinical images.Methods Fifty-seven newborns suspected intracranial hemorrhage were entered into the study and underwent MSCT scans.Original images at three anatomic levels (posterior fossa, basal ganglia, centrum semiovale) were collected and synthetic noise was added so as to simulate dose reductions of 25%, 40%, 50% and 70%, respectively by using the noise addition tool.A total of 855 image data sets were obtained for the 57 patients.Original and simulated dose-reduction scan images were analyzed.Image noise and image quality were assessed by two independent experienced pediatric radiologists using diagnostic acceptability score, subjective image noise score on a 5-peint scale and objective noise index.Image noise was measured by respectively placing region of interest (ROI) at cerebellum, thalamus and corona radiata of 3 different slices.And the noise index and mean value was calculated.The degree of inter-observer concordance was determined by Kappa statistical analysis.The Spearman statistical correlations between the noise index and diagnostic acceptability score were performed.Results On the images of original dose and simulated dose reductions of 25%, 40%, 50% and 70%, the diagnostic acceptability was 4.47±0.51, 3.96±0.33, 3.21±0.45, 2.92±0.32, and 1.85±0.57, respectively,the subjective image scores were 1.62±0.48, 1.99±0.48, 2.76±0.81, 3.19±0.67, and 4.27±0.54, respectively, the noise index were 1.90±0.19, 2.17±0.20.2.44± 0.25, 2.68±0.28, and 3.37±0.39, respectively.The two radiologists had good intembserver agreement for diagnostic acceptability (K=0.860, P=0.017) and for image noise scoff ng (K=0.630, P=0.022).There was significant statistical correlation between image noise index and diagnostic acceptability (r= 0.826,P=0.001).At 40% dose reduction to the standard protocol, the noise index was 2.44 and the image quality score was 3.21 which were considered clinically acceptable.Conclusion The study revealed that acceptable imagos could be obtained with mean noise index of 2.44 and 40% dose reduction.

Objective To observe the efficacy, safety and feasibility of the four kinds of anticoagulation method in hemodialysis patients with high risk of hemorrhage. Methods 128 patients with high risk of hemorrhage who had undergone hemodialysis were randomly divided into four groups. In group A, 68patients were resorted with 30% regional sodium citrate anticoagulation(RCA). In group B, 60 patients were treated with local heparin anticoagulation. In group C, 64 patients were treated with low molecular weight heparin (LMWH). In group D, 66 patients received no heparinization hemodialysis. The changes of bleeding, clotting function, adverse effect and nursing strategies were studied. Results All patients of group A completed regular hemodialysis with satisfactory indices, 6 cases with bleeding and primary bleeding aggravated in group B, 8 cases with bleeding and primary bleeding aggravated in group C, 8 cases occurred grade three coagulation and finished dialysis in group D. 3 cases in group A and 2 cases in group B occurred adverse reaction, but no adverse reaction was seen in group C and D. Conclusions RCA is safe,effective and can be easily handled in regular hemodialysis. It is an ideal dialysate for hemodialysis in patients with high risk of hemorrhage.

Objective To evaluate the predictive value of plasma atrial natriuretic peptide (ANP) level on prognostic of patients with systemic inflammatory response syndrome by dynamic monitoring ANP levels.Methods Ninety-eight patients admitted to the intensive care unite were classified into survival group(n =78) and death group (n =20).The level of plasma ANP,procalcitonin,C-reactive protein and lactic acid were measured.Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score were recorded.Results The plasma ANP level of patients in the death group was 0.40 (0.26) μg/L,significantly higher than that in the survival group(0.22(0.12) μg/L,P =0.000).Along with treatment scheme,the plasma ANP level decreased in survival group,and there were significant difference among three times (0.22 (0.12) μg/L,0.17 (0.09) μg/L,0.13 (0.11) μg/L,P =0.000).But there was no difference in ANP level of patients in death group along with the disease developing (0.38 (0.30) μg/L,0.39 (0.23) μg/L,0.39 (0.22) μg/L,P =0.99).ICU hospitalized time in survive group associated with APACHE Ⅱ score,ANP and PCT(r =0.735,0.628,0.487 respectively,P =0.000,0.001,0.021).Conclusion ANP is proved to be a good clinical index in prognostic evaluation of patients with sepsis.