BACKGROUND:It is an important and complex issue for the incidence of bacterial infection and complications after transplantation. The monitoring and care after transplantation can improve the success rate of transplantation. OBJECTIVE:To search the database of China National Knowledge Infrastructure, North American Clinical Trial Register and Thomson Reuters Web of Science database, and to perform literature metrological analysis and clinical trials registration project analysis on the published literatures of the monitoring and care after transplantation. METHODS:A total of 138 literatures were searched with the key words of“intensive care, transplantation”in the database of China National Knowledge Infrastructure on the intensive care after transplantation. 23 literatures were used for further analysis by reading titles and abstracts and 115 papers were excluded; the Thomson Reuters Web of Science database was searched with the key words of“intensive care, transplantation”for the literatures on the intensive care after transplantation published from 2008 to 2013;the North American Clinical Trial Register was searched with the key words of“intensive care, transplantation”for the related clinical trials, and a total of 50 registered projects were obtained, only 10 interventional studies. RESUTLS AND CONCLUSION:In recent years, the literatures on the intensive care after transplantation show a gradual increase trend. Compared with international research, fewer researches in this field emerge in China, literature quantity and quality need to be improved. There have been 1 693 papers published in the Thomson Reuters Web of Science database regarding the intensive care after transplantation. United States published the most literatures than other countries, total 532 papers, accounting for the largest proportion, 31.424%of total literatures. Transplantation Proceeding published the most literatures, total 144 papers, accounting for 8.506%of total literatures. There are 50 clinical trial registration projects related to the intensive care after transplantation in the North American Clinical Trial Register, 10 of them were interventional study, accounting for the majority, fol owed by observational study. Diagnostic study had no related registration projects. The surgery of transplantation was complex with trauma. The early monitoring and care post-transplantation are directly related to the success of surgery. Strengthening the monitoring and care of patients’ vital signs, rejection, bacterial infections and other aspects can reduce the complications and improve patients survival rate and quality of life.

Positron emission tomography-computed tomography (PET-CT) plays an important role in the diagnosis and treatment of liver cancer.18F-FDG PET-CT imaging-positive rate is low due to a variety of factors affecting the hepatoma cells.But the joint imaging can significantly improve the diagnostic positive rate and provide the basic information for treatment selection and prognosis.PET-CT is better than conventional imaging techniques in the diagnosis and therapy monitoring for metastatic liver cancer.

AIM: To observe the effect of adrenocorticotropic hormone(ACTH) on the levels of brain-derived neurotrophic factor (BDNF), trkB and corticotropin-releasing hormone(CRH) in the hippocampus of arthritic rats.METHODS: The BDNF immunoreactivity (IR) and CRH-positive neurons were stained with immunohistochemistry and in situ hybridization methods, respectively.RESULTS: The BDNF-IR, CRH mRNA-positive neurons in the contralateral hippocampus of the arthritic rats were increased significantly, which was decreased markedly by intraperitoneal injection of ACTH. However, the effect of ACTH was attenuated after adrenalectomy (ADX).CONCLUSION: These results suggest that BDNF and CRH in the hippocampus of arthritic rats were involved in the modulation of chronic pain, ACTH produced its analgesic effect by inhibiting the increase in BDNF and CRF level. Adrenal is critical to the analgesic action of ACTH.

Objective To investigate the value of MRI in diagnosis and assessing anatomical distributions of posterior deep infil-trating endometriosis (PDIE)using laparoscopic surgical findings as reference standard.Methods MR images of 36 patients with laparoscopic operation and pathology confirmed PDIE were retrospective analysis,and results were compared with laparoscopic sur-gical findings.Results Among the 36 patients,PDIE was identified in 34 patients at MR imaging with a sensitivity of 94.4%.Re-garding different anatomy location,the accuracy of MR imaging in diagnosis of endometriosis in uterosacral ligament (USL),re-ctosigmoid bowel,rectovaginal septum and vagina was 83.3%,91.7%,80.6% and 91.7% ,respectively.MR imaging findings were well correlated with laparoscopic surgical findings.Conclusion MR imaging can diagnose and assess the anatomical distribu-tions of PDIE with high accuracy preoperatively,which provides useful information for therapy plan making.

Objective:To investigate the long-term efficacy of oral appliance treating of obstructive sleep apnea and hypopnea syndrome (OSAHS) in different periods of treatment.Methods:A total of 55 patients were included in the study.Patients were all diagnosed with OSAHS by overnight polysomnography and all received oral appliance (OA) as the therapy.The OA positioned the mandible at 60％-70％ of the maximal mandible advancement position and created a 4-5 mm incisor separation.The patients were instructed to wear the appliance during sleep,6-8 hours per day,for 5-7 days per week.They were divided into four groups by the period of treatment,including less than 1 year group;1-2 years group;2-6 years group and 6-9 years group.The polysomnographic study was used to investigate the efficacy of the four groups.The outcome measures included the score on the apnea-hypopnea index (AHI),the longest apnea time and the lowest oxygen saturation (LSaO2) levels during an overnight sleep.Results:The AHI decreased significantly in all the four groups.The less than 1 year group decreased from 24.50 (14.65,54.05) to 7.40 (2.12,10.00) events/h (P ＜ 0.001);The 1-2 years group decreased from 19.50 (12.15,39.23) to 1.80 (0.70,6.58) events/h (P =0.001);The 2-6 years group decreased from 25.00 (11.41,42.60) to 4.50 (1.35,7.90) events/h (P =0.001);The 6-9 years group decreased from 26.2 (16.95,47.45) to 4.00 (1.90,26.70) events/h (P =0.043).The longest apnea decreased significantly in less than 1 year group,1-2 years group and 2-6 years group.The longest apnea decreased from 57.00 (37.70,61.50) to 25.00 (15.90,33.50)seconds (P＜0.001) in the less than 1 year group,from 41.00 (25.50,62.26) to 13.10 (0.00,22.10) seconds (P =0.001) in the 1-2 year group and from 42.50 (30.35,58.15) to 15.60 (0.00,28.10) seconds (P =0.003) in the 2-6 year group.The LSaO2 levels increased significantly in the less than 1 year group and 2-6 years group.The LSaO2 levels rose significantly in the less than 1 year group,from 74.18％ ±7.96％ to 84.06％ ±7.67％ (P =0.001),and in the 2-6 years group,from 76.71％ ± 10.98％ to 84.06％ ±4.64％ (P =0.006),The LSaO2 levels did not increase significantly in the 1-2 years and 6-9 years groups.Kruskal-Wallis test showed that there were no statistically significant differences in the AHI,longest apnea time and LSaO2 in 4 the groups.Conclusion:The oral appliance is an effective therapy for patients with OSAHS in the long-term treatment.However,it's recommended to make appointments with patients as a follow-up supervision whether there is any efficacy decrease.And the oral appliance should be replaced if necessary.

Objective To investigate the riskf actors associated with sepsis following surgery of con-genital heart disease in children, for early-recognizing and diagnosing, improving prognosis and decreasing mortality.Methods Retrospective study wa s employed,52 patients of sepsis and 104 patients of non-sepsis with similar age,sex,na d the same diseases were enrolled during Jan 2012 to Apr 2015 in cardiac intensive care unit.Variables such as age,sex,preoperative infection,delayed sternum closure,diaphragmatic paralysis, exploraot ry chest,cardiopulmonaryb ypass time, placed invasive catheter were included in the research fac-tors.The Logistic regression model was set up,OR and 95%CI were calculta ed.Results In sepsis group,the more shock and dysfunction organs,longre hospital stays,longer ICU stays and higher mortality were found compared to the non-sepsis group[25.32%vs.6.73%,3.5 ±1.1 vs.1.1 ±0.7,(35.1 ±11.2)d vs.(11.3 ±3.1)d,(21.3 ±7.1)d vs.(7.1 ±2.3)d,19.23%vs.4.81%,P<0.05].In the Logistic regres ion mod-e l,variables significantly associated with sepsisw ere preoperative infection,deal yed sternal closure,explorato-ry chest,and placed more invais ve duct,diahp ragmatic paralysis(P<0.05).OR value (95%CI) were 10.53 (1.73,64.2),26.66(2.69,263.83),19.47(1.87,203.02),4.99(1.36,18.31),8.32 (0.12,16.46 ), respectively.Conclusion Preoperative infection,delayed sternal closure,exploratory chest,placed more inva-sive duct,diaphragmatic paralysis are the risk factors of sepsis.Children with sepsis had poor clinical outcome compared to those without sepsis.

BACKGROUND: Electromagnetic pulse (EMP) irradiation can cause the decline of learning and memory abilities of rats, and lead to the intracellular calcium overloading of hippocampal neurons in vitro, and then result in necrosis and apoptosis. Physical shield can alleviate the damage of electromagnetic irradiation on experimental animals, but studies of the medicine prevention and protection on cell models are still in lack.OBJECTIVE: To observe the possibility of medicine in preventing and protecting the EMP-induced injury of hippocampal neurons in vitro.DESIGN: A randomized controlled animal experiment.SETTING: Division of Basic Medical Sciences, Chengde Medical College.MATERIALS: The experiments were carried out in the Academy of Military Medical Sciences and Chengde Medical College from January 2004 to January 2005. Several neonatal Wistar rats were used.METHODS: The neonatal Wistar rats were killed by cutting heads to remove brain, and the hippocampal neurons were primarily cultured and identified. After pretreatment with MK801 [N-methyl-D-aspartate (NMDA)receptor antagonist] and nifedipine (L-type Ca2+ channel blocking agent),the primarily cultured hippocampal neurons were irradiated with EMP. The condition of our experiment was 6×l04 Y/m, pulse rise time was 20 ns,pulse width was 30 ms, and frequency was 2.5 pulse per minute for 2 minutes. The neurons cultured in special petri dish, which could be observed under LSCM high amplified resolution, were divided into EMP irradiation group, MK801 20 μmol/L group, MK801 20 μmol/L+ nifedipine 1 μmol/L group. The cellular activities were detected with methyl-thiazol-tetrazolium (MTT) colorimetry; The rate of apoptosis was detected with FASC method;The intracellular free Calcium concentration ([Ca2+]i) was determined by loading with Fluo-3-AM Ca2+ fluorescent probe (Molecular Probes Company) on the laser scanning confocal microscope.MAIN OUTCOME MEASURES: The intracellular calcium overloading,cellular activity and rate of apoptosis were compared.RESULTS: ① The [Ca2+]i fluorescent intensity in the EMP irradiation group immediately after irradiation was significantly higher than that in the normal control group (107.34±26.14, 54.93±16.08, P＜0.05); As compared with the EMP irradiation group, the [Ca2+]i fluorescent intensity was decreased in the MK801 20 μmol/L group (81.29±19.96, P ＜ 0.05), and further decreased in the MK801 20 μmol/L+ 1 μmol/L nifedipine group (69.82±25.54, P＜0.05), but both were higher than that in the normal control group (P＜0.05). ②The A values that reflected the activity of cell proliferation MK801 20μmol/L group and MK801 20 μmol/L+1 μmol/L nifedipine group (0.25±0.06, 0.27±0.07) were obviously higher than that in the EMP irradiation group (0.17±0.08, P ＜ 0.05), but still lower than that in the normal control group (0.33±0.08, P ＜ 0.05). ③ The rate of apoptosis in the EMP irradiation group immediately after irradiation was significantly higher than that in the normal control group [(68.63±9.04)%, (20.14±4.34)%,P＜0.01]; As compared with the EMP irradiation group, the rate of apoptosis was decreased in the MK801 20 μmol/L group (62.12±11.08)%, and further decreased in the MK801 20 μmol/L± 1 μmol/L nifedipine group [(53.69±13.60)%, P ＜ 0.05], but both were higher than that in the normal control group (P ＜ 0.01).CONCLUSION: Pretreatment with MK801 and nifedipine can partly block EMP induced damage in hippocampal neurons in vitro. Intracellular Ca2+ Overloading may play an important role in the injury of EMP on hippocampal neurons.

Objective　To investigate the expression of LPS receptor-CD14(CD14) on the membrane of Kupffer′s cells (KCs) induced by Lipopolysaccharide (LPS )and its role in activation of KCs and production of cytokines. Methods　KCs were isolated by collagenase perfused Wistar rats and routinely cultured in 24-well dishes for 12 h. Cells were harvested and adjusted to a concentration of 1×106/ml/well and were devided into two groups. Group of LPS: KCs were induced with different concentration of LPS (0, 100 ng/ml, 1 μg/ml and 100 μg/ml). Group of PI-PLC: KCs were pre-incubated for 30 min with one unit of phophatidy linositol specific phospholipase C (PI-PLC) before different concentrations of LPS were added. KCs were cultured for 30 and 60 min respectively. Supernatants were then collected for measuring the level of TNFα and IL-6. Cells were stained by indirect immunofluorescent method ( rabbit anti-CD14 antibody and goat anti-rabbit IgG conjugated with FITC ) and analyzed with flow cytometer (FCM). The percentage and mean fluorescence intensity (FI) of CD14-positive cells were taken as the indexes. Results　In LPS group, after incubation of cells with increasing concentration of LPS, a significant increase in the percentage of CD14 positive KCs were found and the mean FI was stronger when compared with the control points or the group of PI-PLC. The levels of TNFα and IL-6 in supernatant also increased (P<0.01). In group of PI-PLC, decreased percentage of CD14 positive KCs and weakened mean FI were found when compared with group of LPS. The increasing production of TNFα and IL-6 slowed down in the group of PI-PLC. Conclusion　CD14 expression of KCs might be up-regulated by LPS with increase of some cytokines. The production of cytokines in KCs induced by LPS is partially inhibited by PI-PLC.

Objective To analyze the initial response rate of radiotherapy and chemotherapy,and the influence of different treatment modalities on pmgnnsis of primary non-Hodgkin lymphoma(NHL)of the nascl cavity.Methods From January 1993 to December 2002,70 patients were confirmed by histopathology as NHL,including 52 T cell origin,2 B cell and 16 NK cell.The main radiotherapy portal was set in front of the nose with a spade like protrusion,supplement with a portal next to the ear on one side or both sides.Combined portal in facial cervical area was first used when there was invasion of the oropharynx.The median dose to the nasal cavity wag 54.0 Gy with a range of 336 to 66 Gy,given before or during after radiotherapy or alone,consisted of 2-6 cycles chemotherapy of COP,CHOP or COBDP.Prognostic factors were analyzed with Cox model. Results The local control rates was 12.5%, 66.7% and 74.0% in chemotherapy alone,radiotherapy alone,and chemotherapy plus radiotherapy.The 5-year survival rate Wag 12.5%,50.0% and 62.0%,respectively(P＜0.05).Multifaetor analysis showed that tumor extension and treatment methods were the most important prognostic factors besides Ann-Arbor stage,but gender,pathology,age and symptoms had little effect on prognosis.Conclusion Chemotherapy plus radiotherapy group achieved a better survival rate than radiotherapy alone.For some NHL patients with good financial condition,APBSCT is a good choice.

Objective To understand the undergraduate nursing students’ awareness of the basic situation of occupational exposure in Kunming Medical University, and to understand their knowing status of occupational exposure knowledge. Methods We used self- designed questionnaire to investigate 449 undergraduate nursing students in Kunming Medical University to obtain the status of occupational exposure and protection knowledge level of students.Results (1) 449 students were investigated, and 258 of them had been in clinical practice, and occupational exposure occurred in 48.8% of them. (2) Occupational exposure factors included grade, washing hands and wearing gloves;The results showed that:Grade was a risk factor and wearing glove and washing hands were protective factors. (3) There was relevance between accepting the occupational protection education and the occupational exposure. Conclusions A useful measure to reduce the occurrence of occupational exposure is Pre-service training for undergraduates nursing students. Operation should be in strict accordance with operating specifications. Schools and departments should implement occupational protection system, so as to strengthen the related knowledge vocational education,enhance self-protection awarenes,and reduce or minimize the occurrence of occupational exposure.