ObjectiveTo study the effects of intermittent subglottic secretion drainage(SSD)with an endotracheal tube on incidience of ventilator- associated pneumonia(VAP). MethodsWe searched computerized databases,including Cochrane library,Pubmed,EMbase,CBM,CNKI,Wanfang and some relevant databases from initializing to March 2012,extracting data about subglottic secretion drainage(SSD)with an endotracheal tube on incidence of VAP using RCT.The data had Meta- analysis by software RevMan5,and to those data which could not be conversed or merged,they underwent descriptive analysis. ResultsWeidentifled 5 randomized clinical trials that met the inclusion criteria with a total of 683 randomized patients.In Meta- analysis,the overall risk ratio for ventilator- associated pneumonia was decreased significantly by intermittent subglottic secretion drainage with an endotracheal tube.There was no significant difference on adverse events or on hospital or intensive care unit mortality.Databases,including ICU and hospital LOS,duration of endotracheal catheterization,bacteria concentration,which were difficult to be conversed and obtained full data,they underwent a descriptive research. ConclusionsCompared with the common endotracheal tubes,the use of endotracheal tubes with subglottic secretion drainage is effective for prevention of ventilatorassociated pneumonia.But it has no effect on adverse events or on hospital or intensive care unit mortality.So large sample RCTs with multiply- center should be carried out to assess the effect of the use of SSD.

Objective:To assess the nursing care experiences and curative effects of the application of wound care technologies combined with other multiple treatments in the hepatolithiasis patient who suffered from postoperative severe intestinal fistula.Methods:The wound care difficult points were analyzed,the wound care technologies combined with other multiple treatments including multiple debridement methods were applied according to the severity of the intestinal fistula:multiple debridement, new skin protection, continuous flushing and drainage with double cannula, improved negative pressure closure drainage and wound pull-in technology, combined with systemic treatment and nursing intervention.Results:The intestinal fistula was treated for 12 days, and the wound infection was controlled for 24 days. Finally the wound was healed after 43 days and patient was discharged from hospital.Conclusions:In the case of severe intestinal fistula after hepatolithiasis operation, the application of wound nursing technology combined with treatment scheme provides a new treatment idea and scheme for intestinal fistula and wound healing.

Autonomic nervous system activation can result in significant changes of atrial electrophysiology and facilitate induction of atrial fibrillation. By recording influence of different concentrations of acetylcholine (ACh) on atrial fibers (AF), we investigated the role of the increased vagal tone in electrical remodeling in atrial fibrillation. Parameters of action potentials and force contraction (Fc) in atrial fibers were recorded by using standard intracellular microelectrode technique and force transducer. It was found that: (1) ACh at 0.1 μmol/L had no significant influence on spontaneous action potentials (SAPs) and Fc (n=6, P>0.05); ACh at both 1.0 and 10.0 μmol/L shortened action potential duration (APD) and Fc of human AF from right atrium (n=6, P<0.05); there was no significant difference in shortening APD between 10.0 and 1.0 μmol/L of ACh; (2) ACh at 0.1 μmol/L had no significant desensitization (n=6, P>0.05), but ACh at 1.0 and 10.0 μmol/L had desensitization (n=6, P<0.05) to SAPs and Fc. The desensitization of ACh on APD in AF was concentration- and time-dependent. It was shown that APD was longer than the control along with extending time of continuous Tyrode's solution perfusion after desensitization. It is concluded that ACh changes the electrophysiological characteristics of human AF, indicating that increased vagal tone plays a role in the development of a vulnerable substrate for atrial electrical remodeling in atrial fibrillation.

Objective To investigate the in vitro effects of various antibiotics (spectinomycin, ceftriaxone, erythromycin, ofloxacin and doxycycline) against 12 isolates of C. trachomatis. Methods Minimal inhibitory concentrations (MICs ) and fractional inhibitory concentrations (FICs) of the antimicrobials against all C. trachomatis were calculated. Checkerboard method was used for the determination of FICs and Ridit test for the comparison of the interactions among the various combinations. Results No difference was observed in most of the combinations. No antagonism was found in all except for ceftriaxone-doxycycline combination. Synergism was observed in 42% (5 of 12) and 50% (6 of 12) of the chlamydial isolates for erythromycin-spectinomycin and doxycycline-spectinomycin combination, respectively. No significant difference was observed among triple combinations with spectinomycin or with ceftriaxone. When interactions of erythromycin, ofloxacin and doxycycline with spectinomycin were compared to those with ceftriaxone respectively, both interactions of erythromycin (U = 2.46, P = 0.014) and doxycycline (U = 2.83, P = 0.002) were more synergistic with spectinomycin than those with ceftriaxone. Conclusions This study indicates that the combination of spectinomycin with erythromycin or doxycycline is more effective against C. trachomatis than that of ceftriaxone. Therefore, spectinomycin rather than ceftriaxone might be recommended in the dual therapy against C. trachomatis and N. gonorrhoeae.

Background and aim:The transcriptional co-activator Yes-associated protein-1(YAP1)has been impli-cated as an oncogene and is overexpressed in different kinds of human cancers,especially hepatocellular carcinoma(HCC).However,the role of YAP1 has not been reported in residual/recurrent HCC after transarterial chemoembolization(TACE).Our aim is to determine whether YAP1 is overexpressed in the residual/recurrent HCC after TACE. Methods:A total of 105 tumor tissues from 71 patients including 30 cases of primary HCC without prior treatment,35 cases of residual/recurrent HCC post TACE,and 6 cases of hepatoblastoma were included in the immunohistochemical study.YAP1 immunoreactivity was blindly scored as 0,1+,2+or 3+in density and percentages of positive cells. Results:About 33.3％(10/30)of primary HCC without prior treatment showed 2+of YAP1 immunore-activity.While 82.8％(29/35)of residual/recurrent HCCs after TACE treatment displayed 2-3+of YAP1 immunoreactivity,which was significantly higher compared to primary HCC without prior treatment(P=0.0002).YAP1 immunoreactivity was moderately to strongly positive(2-3+)in 100％ of the hep-atoblastoma,particularly in the embryonal components(3+ in 100％ cases). Conclusions:YAP1 is significantly upregulated in the residual/recurrent HCCs post TACE treatment,suggesting that YAP1 may serve as a sensitive diagnostic marker and a treatment target for residual/recurrent HCC post TACE.

Autonomic nervous system activation can result in significant changes of atrial electrophysiology and facilitate induction of atrial fibrillation.By recording influence of different concentrations of acetylcholine (ACh) on atrial fibers (AF),we investigated the role of the increased vagal tone in electrical remodeling in atrial fibrillation.Parameters of action potentials and force contraction (Fc) in atrial fibers were recorded by using standard intracellular microelectrode technique and force transducer.It was found that:(1) ACh at 0.1 μmol/L had no significant influence on spontaneous action potentials (SAPs) and Fc (n=6,P＞0.05); ACh at both 1.0 and 10.0 μmol/L shortened action potential duration (APD) and Fc of human AF from right atrium (n=6,P＜0.05); there was no significant difference in shortening APD between 10.0 and 1.0 μmol/L of ACh; (2) ACh at 0.1 μmol/L had no significant desensitization (n=6,P＞0.05),but ACh at 1.0 and 10.0 μmol/L had desensitization (n=6,P＜0.05) to SAPs and Fc.The desensitization of ACh on APD in AF was concentration- and time-dependent.It was shown that APD was longer than the control along with extending time of continuous Tyrode's solution perfusion after desensitization.It is concluded that ACh changes the electrophysiological characteristics of human AF,indicating that increased vagal tone plays a role in the development of a vulnerable substrate for atrial electrical remodeling in atrial fibrillation.

OBJECTIVE: To investigate the therapeutic mechanism of letrozole, the third-generation aromatase inhibitor, on endometriotic lesions in a rat model and its effect on the apoptosis of ectopic endometrial cells. METHODS: Endometriosis was induced by autotransplanting pieces of uterus onto the peritoneum in rats. The rats with successful ectopic implants were divided into 2 groups: A letrozole group (n=15) and a control group (n=15). The volume, appearance, and histopathology of ectopic implant were determined before and after the treatment. Expression of P450arom, COX-2, bcl-2, and bax in the ectopic implant was detected by immunohistochemistry and RT-PCR in the 2 groups. RESULTS: The volume of ectopic implant in the letrozole group was significantly reduced compared with the control group (P<0.05). The protein and mRNA levels of P450arom and COX-2 in the ectopic implant were significantly decreased in the letrozole group compared with the control group (P<0.05). There was a positive correlation between the expression of P450arom and the expression of COX-2 (r=0.943, P<0.001; r=0.913, P<0.001). The protein and mRNA expression of bcl-2 was significantly decreased (P<0.05), and the bax protein and mRNA expression was significantly increased (P<0.05) in the ectopic implant with an increased bax/bcl-2 ratio in the letrozole group compared with the control group (P<0.05). CONCLUSION Letrozole can obviously reduce the size of ectopic implant through decreasing P450arom and COX-2 expression, suppressing the secretion of estrogen, inhibiting the proliferation, and inducing the apoptosis of ectopic implants.
Animals ; Apoptosis ; drug effects ; Aromatase ; metabolism ; Aromatase Inhibitors ; therapeutic use ; Cyclooxygenase 2 ; metabolism ; Endometriosis ; drug therapy ; pathology ; Endometrium ; metabolism ; pathology ; Female ; Letrozole ; Nitriles ; therapeutic use ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Triazoles ; therapeutic use ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo establish the HPLC method of determining the contents of tripterine in Tripterygii preparations purchased from drugstores.

METHODAn external standard method by HPLC with Hanbon Kromasil C18 column as fixed phase and methanol-1% HAc (83:17) as mobile phase was adopted. The detection wavelength was 425 nm and the flow rate was 1.0 mL x min(-1).

RESULTThe contents of tripterine in TWH F. tablets were between 89.04 and 344.0 microg/tablet, and is higher than those in TWH F. polyglycosidium (14.98-217.80 microg/tablet) and Kunmingshanhaitang tablets (22.32 microg/tablet).

CONCLUSIONThe contents of tripterine, in different Tripterygium preparations vary significantly, and in Tripterygium preparations from different manufacturers and different production lots are being remarkable discrepancy. So it is necessary to enhance quality monitoring and to establish the rational quality control standard for Tripterygii preparations.

Chromatography, High Pressure Liquid ; Drug Compounding ; Drugs, Chinese Herbal ; chemistry ; Linear Models ; Quality Control ; Reproducibility of Results ; Sensitivity and Specificity ; Tripterygium ; chemistry ; Triterpenes ; analysis

BACKGROUND: The symptoms of allergic rhinitis (AR) greatly affect the quality of life (QoL) in the patients with AR. The correlations of nasal response to leukotriene D4 (LTD4) and histamine nasal provocation with health related QoL in AR are not clear. OBJECTIVE: To evaluate the correlations of nasal response to LTD4 and histamine nasal challenge with QoL in AR. METHODS: Patients randomly underwent LTD4 and histamine nasal challenge tests, completed the rhinoconjunctivitis quality of life questionnaire (RQoLQ), and rating the symptom severity score (total symptom score 4, TSS4) in the previous week. The correlations between nasal challenge tests induced nasal responses and QoL in RQoLQ were analyzed. RESULTS: A total of 25 eligible AR patients enrolled and finished both LTD4 and histamine nasal challenge and completed the questionnaire of RQoLQ. Histamine nasal challenge induced sneezing, increased nasal resistant were correlated with most of the dimensions (general, practical, nasal, eye problems, and quality of sleep, p < 0.05), while LTD4 nasal challenge induced sneeze, increased nasal resistant only correlated with nasal and ocular problems. On the contrary, the severity of the sneeze assessed by TSS4, was not correlated with QoL, while the severity of rhinorrhea, congestion, and nasal pruritus were correlated with nasal and practical problems, and nasal congestion was also correlated with ocular problems (r = 0.60, p = 0.01). CONCLUSION: LTD4 and histamine nasal challenge induced nasal responses were correlated with different clinical symptoms severity and QoL, which can be used as a good diagnosis and evaluation methods for the management of AR.
Diagnosis ; Estrogens, Conjugated (USP) ; Histamine ; Humans ; Leukotriene D4 ; Pruritus ; Quality of Life ; Rhinitis, Allergic ; Sneezing

To summarize the nursing experience of a patient with intestinal fistula after laparoscopic extended radical resection of rectal cancer plus ileostomy.Nursing points include:multi-disciplinary joint formulation of systemic treatment and nursing plan;using fistula isolation technology to isolate and drain digestive fluid;implementing incision segmentation management to promote infection control and tissue growth.After careful treatment and nursing care,the intestinal fistula was closed after 38 days of surgery,and the wound healed after 52 days of surgery.