Objective To analyze and summarize the clinical diagnosis and therapy features of chronic liver disease patients with limbs infection.Methods A retrospective analysis was performed on 29 chronic liver disease patients with serious limbs infection in our hospital.Results Chronic liver disease patients with limbs infection specially vibrio infection,had a high ratio of MODS,so early diagnosis,early therapy with antibiotics and early operation to expose and cut lesion has a good effect.Conclusions The chronic liver disease patients with limbs infection should early diagnosed,early treated by antibiotics,and early exposed the swelling limbs or cut lesion by surgery.

Objective To study the effects of DMPS on ET-1 during experimental myocardial ischemia-reperfusion (I/R) injury.Methods 20 New Zealand rabbits were randomly assigned to 2 groups: I/R group and DMPS protection group with 10 in each group. The blood sample was obtained through vien at different time (5 min before ischemia, the end of the ischemia period and 0.5h, 1h, 2h, 4h, 6h after reperfusion ) in each group.The serum concentrations of ET-1 were detected with radioimmunology method. Results The levels of ET-1 of serum and cardiac tissues increased after ischemia and reperfusion, and were significant different compared with that before ischemia(P0.05).Conclusions The changes of ET-1 were significant when myocardial I/R. DMPS may effectively effect the levels of ET-1 after myocardial ischemia and during I/R injury,and have protecfion of myocardium from ischemia and reperfusion injury.

Objective To study the effects of DMPS on IL-1? during experimental myocardial ischemia-reperfusion(I/R)injury.Methods 30 New Zealand rabbits were randomly assigned to 3 groups:I/R group,DMPS protection group and Control group,10 in each group.The blood samples was obtained through vien at different time(5 min before ischemia,the end of the ischemia period and 0.5h,1h,2h,4h,6h after reperfusion)in each group.The serum concentrations of IL-1? were detected with radioimmunology method.Cardiac tissues samples were taken for determination of IL-1?.The ultrastructure changes of the Cardiac tissues were observed.Results The levels of IL-1? of serum and cardiac tissues increased after ischemia and reperfusion,and were significant different comparing with that before ischemia(P

To knock out β-lactoglobulin (BLG) gene and insert human lactoferrin (hLF) coding sequence at BLG locus of goat, the transcription activator-like effector nucleases (TALEN) mediated recombination was used to edit the BLG gene of goat fetal fibroblast, then as donor cells for somatic cell nuclear transfer. We designed a pair of specific plasmid TALEN-3-L/R for goat BLG exon III recognition sites, and BLC14-TK vector containing a negative selection gene HSV-TK, was used for the knock in of hLF gene. TALENs plasmids were transfected into the goat fetal fibroblast cells, and the cells were screened three days by 2 μg/mL puromycin. DNA cleavage activities of cells were verified by PCR amplification and DNA production sequencing. Then, targeting vector BLC14-TK and plasmids TALEN-3-L/R were co-transfected into goat fetal fibroblasts, both 700 μg/mL G418 and 2 μg/mL GCV were simultaneously used to screen G418-resistant cells. Detections of integration and recombination were implemented to obtain cells with hLF gene site-specific integration. We chose targeting cells as donor cells for somatic cell nuclear transfer. The mutagenicity of TALEN-3-L/R was between 25% and 30%. A total of 335 reconstructed embryos with 6 BLG-/hLF+ targeting cell lines were transferred into 16 recipient goats. There were 9 pregnancies confirmed by ultrasound on day 30 to 35 (pregnancy rate of 39.1%), and one of 50-day-old fetus with BLG-/hLF+ was achieved. These results provide the basis for hLF gene knock-in at BLG locus of goat and cultivating transgenic goat of low allergens and rich hLF in the milk.
Animals ; Animals, Genetically Modified ; genetics ; Female ; Fibroblasts ; Gene Knock-In Techniques ; Gene Knockout Techniques ; Goats ; genetics ; Humans ; Lactoferrin ; genetics ; Lactoglobulins ; genetics ; Milk ; chemistry ; Nuclear Transfer Techniques ; Plasmids ; Pregnancy ; Transfection

Objective To study epidemiology, clinical findings, diagnosis and treatment of sepsis caused by Vibrio vulnificus. Method Patientss with Vibrio vulnificus sepsis were collected from 1995 to 2008. The medical records including epidemiological and clinical data were analyzed. Results The male-to-female ratio of 34cases was 4.7:1 and 76. 5% of these patients suffered from chronic liver disease. Most patients occurred from April to October with signs of abrupt fever, characteristic cutaneous lesions, hypotension and progressive multiple organ disfunction syndrome (MODS). The mortality was over 47.1% . The criteria proposed for early diagnosis of Vibrio vulnificus sepsis were abrupt onset with fever during the period from April to November, characteristic cutaneous lesions, such as the most commonly occurred haemorrhagic bullae on the extremities or even extensive necrosis of skin and muscular tissue, progressive hypotension or shock accompanied by MODS, pre-existing liver disease or chronic abuse of alcohol, and consumption of raw seafood or exposure to seawater within 12 week. Early administration of the third-generation cephalosporins with the quinolones in full dosage, aggressive wound debridement,appropriate dermoplasty and supportive care contribute to a better outcome. Conclusions Vibrio vulnificus sepsis progresses rapidly with high mortality. Early diagnosis, rapid treatment with prompt antibiotics and aggressive surgery treatment are very important to improve the outcome.

Objective To study the factors influenceing patients' family members to make own relative fac-tors patients' families making decision on refusal of cardiopulmonary resuscitation (CPR) to the critical patients. Method Data were registered based on Utstein Style of 522 patients aged over 15 years, who subjected to in-hos-pital cardiac arrest(CA) in Department of Emergency of The First Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2008. A total of 157 patients' family made refusal decision among the 522 pa-tients, who belonged to the refusal group, and others belonged to the attempt resuscitation group. The associated factors included age, sex, marriage, household register, cause of CA, underlying diseases, capability of activity before CA, life supported with mechanical ventilation, and administration of pressor agents. The refusal decisions were evaluated by using univariate Logistical regression analysis, and then the statistical significant variables were analyzed by using muhivanate Logistical regression analysis. Results Age, household register, cause of CA(car-diac or traumatic),stroke, sudden death, cancer, capability of activity before CA, life supported with mechanical ventilation,and administration of pressor agents were the important factors of making refusal decision (P < 0.01), but sexes or marriage was insignificant related to the refusal decision (P > 0. O5). The independent risk factors re-lated to refusal decision were age (P = 0.034),cancer (P = 0.006),stroke (P = 0.003), and life supported with mechanical ventilation (P = 0.000) in multivariate Logistical regression analysis, but the protective factors were sudden death (P =0.000),cardiac CA (P =0.020) and traumatic CA(P =0.000). Conclusions Age over 60 years, cancer, stroke, and life suppoted with assisted ventilation before CA were factors associated with re-fusal decision making, yet sudden death, cardiac CA and traumatic CA were factors of accepting CPR.

Objective To survey cervical myoelectric signals during craniocervical flexion, neutral and extension postures, and to explore the evidence that proper head position can alleviate cervical muscle fatigue in a lateral recumbent position. Methods Surface electromyography (sEMG) signals were detected from the sternocleidomastoid, upper trapezius and erector spinae muscles of 30 young subjects bilaterally during craniocervical flexion,neutral and extension postures in the left lateral recumbent position. The integrated trace area (IEMG) and median frequency (MF) were estimated. Results The average IEMG of the sternocleidomastoid muscles was significantly lower in flexion than in extension bilaterally. The average IEMG of the erector spinae muscles was lower in extension than in flexion bilaterally, and the difference was again significant. The IEMGs of the upper trapezius muscle showed no significant difference on average in the three postures bilaterally. There was no significant MF difference in any of the muscles. Conclusions The muscles in the cervical back were less activated during craniocervical extension in a lateral recumbent position. A little cranicocervical extension is optimal while resting in a lateral recumbent position.

Objective,This study was designed to evaluate the predictive value of pre-procedure Cardiac troponin I(cTnI)and CRP levels in patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI).Methotis cTnI and CRP were determined on admission in 335 consecutive patients with ACS who underwent primary PCI.Blood samples were obtained within 6-10 h after onset of symptom.The concentration of cTnI was determined by an automated chemiluminescence immunoassay.CRP was measured by immunoassay assay.According to the admission cTnI(＜0.1,0.1-0.5,＞0.5μg/L)and CRP(≤3,＞3 mg/L)divided into different groups.The pre-procedure cTnI and CRP status associated with 30 days cardiac mortality and major adverse cardiac events(MACE.including cardiac death.non-fatal recurrent MI.heart failure.readmission for any reason)were analyzed.The cardiac mortality at follow.uD period of 2 years were analyzed.Results Muhivariate logistic regression analyses revealed preoperative cTnI predicted 30 days cardiac mortality(OR=3.5,95%CI 2.2-5.3,P＜0.01),and recurrent MI rate(OR=1.5,95%CI 1.1-2.6,P＜0.05),independent of other known prognostic factors such as age,gender,hypertension,Hypercholestemlemia,diabetes and smoking.The pre-procedure CRP was independently related to 30 days cardiac mortality(OR=1.6,95%CI 1.1-2.3.P＜0.05),whereas there was no relationship to the MI rate.In ACS,levels of CBP≤3 mg/L,the three different risk groups (cTnI＜0.1,0.1-0.5,＞0.5μL)with corresponding 30 days MACE rates of 4.3%,11.7%,18.8%(X~2=4.829,P=0.028),CRP＞3 mg/L,the three groups mth corresponding 30 days MACE mtes of 5.5%,13.2%,21.1%(X~2=5.862,P=0.015),respectively.Patients were followed up for 2 years,Kaplan-Meier survival analysis demonstrated a significantly reduced survival at 2 years in patients witll a cTnI ＞0.5μg/L(80.0%versus 89.1%for a cTnI of 0.1-0.5μg/L and versus 92.2%flor cTnI＜0.1μg/L;X~2=7.571,P＜0.05 by log-rank).Conclusions The levels of CRP and cTnI in Acs of onset in 6-10 h provide an even better risk stratification after the PCI.and closely correlate with 30 days MACE.Elevated cTnI provides long-term prognostic information regarding cardiac mortality.Therefore.The combination of CRP and cTnI measurement should be taken into consideration for risk stratification to decide about the management strategies in ACS patients.

Objective To investigate the changes of tissue factor(TF)and tissue factor pathway inhibitor(TFPI)at different time points after in-hospital eardiopulmonary resuscitation(CPR).and to explore the role of TF and TFPI in CPR.Method From September 2005 to September 2007,24 patients,who suffered from cardiac arrest,were selected from the of emergency medicine department,The First Affiliated Hospital,Wenzhou Medical College.The selected patients were older than 16 years old and had identified cardial :arrest time.All patients were randomly classified into two groups:those who had retum of spontaneous circulation(ROSC)(n:12)and those mthom ROSC(n=12).Ten normal healthy volunteers served as control subjects(n=10).Etiology of the car.diac arrest and clinical characteristics during eardiopulmomry resuscitation were emestered.Serial levels of"IF and TFPI at different time points of 30 min,60 min,6 h,24 h,48 h after CPR were measured by enzyme linked immunosorbent assay(ELISA)after eardarrest and CPR.Data Were expressed as mean±standard deviation twotailed t test and ANOVA and four flod table chi-square test were used for eomparisoll in SPSS 11.5 software,and chaangs were considered as statistically significant if P value was less than 0.05.Results Inpatients with ROSC.TF obviously increased at 30 min after CPR.reached peak at 6 h.1F levels in patients without ROSC wer higher compared to those of the control group and ROSC at the same time point.The levels of TPFI had no significantly differentce at 50 min after CPR,and TFPI,obviously elevated at 60 min after CPR in ROSC group compared to those ofthe control group and without-ROSC group.In comparison with control group,the ratio of TF/FPI at 30 min after CPR in without-ROSC group and ROSC group were marked elevated.The ratio of in without-ROSC group showed marked devations eompare,t to that of ROSC group.In R()sC group.the ratio of THFI peaked at 6 h after CPR and descended a after CPR.Conclusions'11le 1F and TFPI level8 after CPR in patients with in-hospital cardiac obviously increase.The levels of TF and TF/TFPI at 30 min after CPR can be used for predicting the prognosis of patients with in-hospital cardiac arrest.

This article described the background,concept,characteristic and objective of the research-based nursing,systematically introducing the main measures including management mechanism, nursing service,nursing staff training,and nursing scientific development.Other areas covered include innovation management mechanism,updating service philosophy,improving nursing staff training,and constructing scientific research platform.