OBJECTIVE To study and find reasonable methods of nursing care of incision through analyzing the risk factors in liver transplant patients.METHODS A total of 416 liver transplantation operations in our hospital from Sep 2004 to May 2006 were evaluated.The risk factors that resulted in the incision infection were considered.RESULTS The incision infection rate was decreased from 13.9% to 4.3% after improvement.CONCLUSIONS Nursing care is of great significance in preventing the incision infection in liver transplant patients.

Objective To investigate the assessment methods and mechanisms of nonsteroidal antiinflammatory drugs (NSAID)-induced injury in rat small intestinal epithelial barrier,and to explore the protective effects of mucosal protective agents and antacids on it.Methods A total of 96 rats were evenly divided into the morphologic observation group and the mechanism research group,and 48 in each group.Then each group was evenly divided into eight subgroups:the healthy control group,the model group (model established with indomethacin),the teprenone prevention group,the rabeprazole prevention group,the treatment control group,the teprenone treatment group,the rabeprazole treatment group and the teprenone and rabeprazole combined group (combined group),six in each group.Exfoliated cells gap density of small intestine of each subgroup was determined by confocal laser endomicroscopy.Serum level of tumor necrosis factor-α (TNF-α)was measured with enzyme-linked immunosorbent assay (ELISA). The expression of nuclear factor-κB (NF-κB),caspase-3,zonula occludens-1 (ZO-1 )and occludin at protein level was detected by Western blotting.The LSD-t test or Hamhane′s T2 test was performed for statistical analysis.Results The exfoliated cells gap densities of the teprenone prevention group and the rabeprazole prevention group were (57.43 ± 24.55 )/1 000 and (59.80 ± 21 .14 )/1 000,respectively, which were both lower than that of the model group ((110.93±50.58)/1 000),and the differences were statistically significant (t= 53.50 and 54.13,both P < 0.01 ).The exfoliated cells gap density of the combined group was (40.53 ±15 .39)/1 000,which was lower than that of the treatment control group ((93.80±40.65 )/1 000 ),and the difference was statistically significant (t =44.27,P <0.01 ).The serum levels of TNF-α of the teprenone prevention group and the rabeprazole prevention group were (25 .80±8.97)ng/L and (22.74 ±7.15 )ng/L,repsectively,which were both lower than that of the model group ((44.48 ± 7.42 )ng/L),and the differences were statistically significant (t = 18.68 and 21 .74,both P <0.01 ).The serum level of TNF-αof the combined group ((13.66 ±4.98)ng/L)was lower than that of the treatment control group ((24.67±6.70)ng/L),and the difference was statistically significant (t = 9.02,P < 0.01 ).The caspase-3 levels of teprenone prevention group and rabeprazole prevention group were 1 .47 ±0.35 and 1 .58 ±0.34,and the NF-κB levels of these two groups were 1 .27±0.14 and 1 .21 ± 0.10,respectively.Compared with those of model group (2.44 ± 0.45 and 1 .69±0.13),the differences were statistically significant (t =0.97,0.86,0.42 and 0.48,respectively, all P <0.01 ).The levels of caspase-3 and NF-κB of the combined group were 0.66±0.06 and 0.44 ± 0.21 ,respectively,which were lower than those of the treatment control group,and the differences were statistically significant (t=0.34 and 0.56,both P <0.01).The expressions of occludin at protein level of the teprenone prevention group and the rabeprazole prevention group were 0.69 ±0.16 and 0.74 ±0.11 , and the levels of ZO-1 were 0.81 ± 0.08 and 0.84 ± 0.12.Compared with those of the model group (0.45 ±0.22 and 0.64±0.07 ),the differences were statistically significant (t =0.24,0.29,0.17 and 0.21 ,respectively,all P <0.01 ).The levels of occludin and ZO-1 of the combined group were 2.50 ± 0.46 and 1 .76±0.18,which were higher than those of the treatment control group,and the differences were statistically significant (t =1 .50 and 0.76,both P <0.01 ).Conclusions The exfoliated cells gap density may be a valuable indicator to predict the degree of inflammation response and permeability of epithelial barrier as well as to evaluate efficacy of medication.Teprenone and rabeprazole have prevention and treatment effects on NSAID-induced injury in rat small intestine.

Objective To measure and analyze Varian Clinac 21EX accelerator induced radioactivity,and to provide specific recommendations and ways of radiation protection for radiotherapy technicians.Methods To simulate the working environment of radiotherapy technician,and to detect induced radioactivity variation of Varian Clinac 21EX accelerator that induced by 15 MV X-rays under different conditions of beam field area,dose,time,distance and by high energy electron beam (12,16,20 MeV)at the different time.Results The induced radioactivity level was not influenced by different beam field area,and was increased with increasing dose (r =0.930,P ＜ 0.05),decreased with time increase (r =-0.84,P ＜ 0.05),decreased with distance increase(r =-0.975,P ＜ 0.05).The induced radioactivity attenuation levels of the different doses at the same time are different,and have the common characteristic that the induced radioactivity attenuation rate is faster in the initial times.The induced radioactivity levels of high energy electron beams were significantly lower than those of high-energy X-rays.Conclusions During radiotherapy positioning,it is necessary to take measures to protect against the induced radioactivity when high-energy rays with energy greater than 10 MeV will be used.The radiotherapy technician should take the different time and energy interval steps for the different ray type and energy and dose in order to meet the radiation protection principle of optimization.

Objective To explore the relationship of X-ray exposure parameters and false-node rate during image-guidance treatment with CyberKnife spine tracking.Methods Using spine tracking planning on a chest phantom,several combinations of X-ray exposure parameters were used to locate.The false-node ratio and the surface absorbed dose were investigated and the radiation dose was optimized.Results The false-node ratio and surface absorbed radiation dose decreased when the X-ray exposure parameters increased until they saturated.In the range of ≤5.0％ false-node rate,the surface absorbed radiation dose was 0.11,0.26 mGy,and 0.31-0.46 mGy,when the false-node rate was 2.77％,1.07％and 1.0％,respectively.Conclusions In image-guided treatment of CyberKnife,the radiation dose would be optimized,and the patient's radiation dose would be reduced greatly,which is important to protect the patients.

Objective:To investigate the predictive value of matrix metalloproteinase-9 (MMP-9) and neutrophil to lymphocyte ratio (NLR) in delayed perihematomal edema (dPHE) after spontaneous intracerebral hemorrhage (sICH).Methods:Patients with sICH admitted to Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School within 24 h of onset from January 2018 to June 2020 were enrolled retrospectively. Serum MMP-9 levels and peripheral blood cell counts were detected, and NLR were calculated within 24 h of onset. dPHE was defined as an increase of 3 ml in absolute edema volume at 10-21 d after onset of sICH compared with that at 5-9 d. The demographic and baseline clinical and imaging data of the dPHE group and the non-dPHE group were compared. Multivariate logistic regression analysis was used to identify the independent predictors of dPHE. The receiver operating characteristic (ROC) curve was used to evaluate the predictive values of MMP-9 and NLR for dPHE. Results:A total of 195 patients with sICH (61.88±10.60 years old) were enrolled in the study. One hundred and forty-eight patients were males (75.9%). There were 53 patients (27.2%) in the dPHE group and 142 (72.8%) in the non-dPHE group. Univariate analysis showed that age, baseline hematoma volume, baseline National Institutes of Health Stroke Scale score, fasting blood glucose, high-sensitivity C-reactive protein, MMP-9, neutrophil count, NLR and the proportion of irregular hematoma in the dPHE group were significantly higher than those in the non-dPHE group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for confounding factors, higher MMP-9 (odds ratio [ OR] 4.291, 95% confidence interval [ CI] 2.041-6.590; P=0.007) and higher NLR ( OR 2.530, 95% CI 1.157-4.022; P=0.011) were all the independent predictors of dPHE. ROC curve analysis showed that the area under the curve of MMP-9 for predicting dPHE was 0.819 (95% CI 0.756-0.884; P<0.001), the optimal cut-off value was 164.0 μg/L, and the sensitivity and specificity were 86.79% and 66.90% respectively. The area under the curve of NLR for predicting dPHE was 0.788 (95% CI 0.719-0.856; P<0.001), the optimal cut-off value was 5.683, and the corresponding sensitivity and specificity were 77.36% and 71.13% respectively. Conclusions:sICH patients with higher baseline MMP-9 and NLR are more likely to develop dPHE. Early detection of MMP-9 and NLR in peripheral blood after admission can predict dPHE.

Background Neovascular glaucoma is a type of refractory glaucoma.Biological amnion combined with glaucoma valve implantation is a primary therapy and its long-term effectiveness is noticeable. Objective The goal of this Survey was to evaluate the effectiveness of biological amnion combined with glaucoma valve implantation for neovascular glaucoma and compare the clinical outcome with simple glaucoma valve implantation. Methods This was a retrospective observational case series.The clinical data of 44 eyes of 44 patients received biological amnion combined with glaucoma valve implantation for neovascular glaucoma and 43 eyes of 43 patients received simple glaucoma valve implantation for neovascular glaucoma were retrospectively analyzed and compared.The age,sex and disease-cause were matched between these two groups.Patients were followed-up for 24 months after operation.Surgery success was identified as the intraocular pressure(IOP)<21 mmHg after operation.Written informed consent was obtained from each patient prior to the operation.Results The IOP was<21 mmHg throughout the follow-up duration in both groups.No significant difierence was found in the IOP value in 1 week after operation between two groups(t=-5.34,P=0.60).However,IOP values were lower in biological amnion combined with glaucoma valve implantation group in 3,12 and 24 months after operation than those of simple glaucoma valve implantation(t=6.64,t=5.00,t=7.81,P<0.01).Operation successful rates in biological amnion combined with glaucoma valve implantation group were 97.73％.93.18％。90.24％and 82.05％in 1 week,3 months,12 months and 24 months respectively after operation.and those in simple glaucoma valve implantation were 95.35％,71.43％,65.00％and 60.53％in corresponding time points,showing considerably significant differences between two groups (χ2=7.06,χ2=7.47,χ2=4.37,P<0.05).There was no significant difference in Ihe number of eyes with complication between the two groups(P>0.05). Conclusion The biological amnion combined with glaucoma valve implantation surgery may be more effective and safe for the treatment of neovascular glaucoma than with glaucoma va]ve only.

·AIM: To study the expressive variation of Nogo-A on rat retina in the process of chronic ocular hypertension. · METHODS: Thirty-six healthy adult male Wistars were randomly divided into control group (6 rats) and chronic hypertension group (30 rats). Chronic hypertension was created by cauterizing the superficial scleral veins. Immunohistochemistry technique was used to evaluate the expressive varieties of Nogo-A at different time points during the course of chronic ocular hypertension. · RESULTS: The success of the model was indicated by over 40% of increase in the IOP as compared with normal rats. Compared with control group, as time passed chronic hypertension group gradually had detectable morphology changes in the retina. At the 21st day of chronic ocular hypertension, retinas became thinner and the quantity of retinal ganglion cell (RGC) decreased (P<0.05). Assoicated with the morphological changes, the expression of Nogo-A was strongly increased (P<0.05).CONCLUSION: Myelin associated protein Nogo-A plays a part in the process of chronic ocular hypertension.

Objective To explore the changes of PH values of N,O-CMC/β-TCP compositive materials with different mass fractions in simulated body fluids (SBF)and their influence in the growth of MG63 cells, and to illustrate their mechanisms, and to provide reference for the further research on the bone repair materials. Methods The N,O-CMC/β-TCP with mass fractions of 2/1,1/1 and 1/2 were used as experimental groups,and the collagen nano calcium phosphate bone repair material as control group. The materials with different mass fractions were immersed in SBF and the pH values were measured by pH meter after soaking for 7,14,21 and 28d,respectively.The MG63 cells with the concentration of 1 × 105 mL-1 were inoculated and co-cultured in experimental and control groups,the adhesion and morphological changes of MG63 cells in each group were observed by scanning electron microscope and the cell proliferation was detected by MTT method after co-culturing for 2,4 and 6 d.Results The pH values were 6.70-7.25 in N,O-CMC/β-TCP (1/2)group and N,O-CMC/β-TCP (2/1)groups and the pH value in N,O-CMC/β-TCP (1/1)group was basically 7.15. The cells in N,O-CMC/β-TCP (2/1)group formed owe full,spreading face small and less secretion,but the cells in N,O-CMC/β-TCP 1/2 and 1/1 groups formed in full, pseudopodia interconnection, widely spreading and more secretions under electron microscope. The proliferation rate of the cells in N,O-CMC/β-TCP with (1/1 ) and N,O-CMC/β-TCP (2/1)groups had no statistical difference compared with control group (P>0.05),but there was significant difference between control group and N,O-CMC/β-TCP (1/2)group (P<0.05).Conclusion The changes of pH values of N,O-CMC/β-TCP materials with different mass fractions in SBF are small and the pH values are neutral;the order of the mass fraction of N,O-CMC/β-TCP to promote the growth of MG63 cells is 1/1,2/1,and 1/2.

OBJECTIVE To explore kinetic features and its underlying mechanism of the positive inotropic effect of liguzinediol(LZDO)in rats. METHODS ①An In vivo study was made to record the effect of LZDO 20 mg · kg-1 injected for 30 consecutive min from the left external jugular vein on pressure-volume relationships. ②Ex vivo study was used to record the antagonistic effect of LZDO on reduced contractility induced by caffeine. Caffeine and LZDO were perfused as follows:normal perfusion solution, caffeine 0.5 mmol · L-1,and then caffeine 0.5 mmol · L-1+LZDO 100 μmol · L-1. ③ Ca2+ transient from cardiomyocyte sarcoplasmic reticulum (SR) was measured to analyze the effect of LZDO on Ca2 +release blocked by thapsigargin. Thapsigargin and LZDO were perfused as follows:normal perfusion solution,thapsigargin 2 μmol · L-1,and then thapsigargin 2 μmol · L-1+LZDO 100 μmol · L-1.④The SR vesicles were prepared and the effect of LZDO(1,10 and 100μmol·L-1)on sarcoplasmic reticulum Ca2+ATPase(SERCA2a)activity was determined according to the ultramicro-Ca2+-ATP enzyme kit. RESULTS ① LZDO 20 mg · kg- 1 significantly reduced the end-systolic volume (Ves) and enhanced the end-systolic pressure (Pes),stroke volume (SV),ejection fraction (EF),cardiac output(CO),peak rate of rise of left ventricular pressure(+dp/dtmax)and stroke work(SW)(P<0.05). However,LZDO 20 mg · kg-1 did not significantly change the heart rate(HR )or the end-diastolic volume (Ved). ② Caffeine 0.5 mmol · L- 1 significantly enhanced HR,left ventricular developed pressure (LVDP ),and+dp∶dtmax at 5 min after caffeine and decreased at 30 min. However,LZDO 100μmol·L-1 restored the reduced HR,LVDP,and+dp/dtmax induced by caffeine at 30 min(P<0.05).③Thapsigargin 2μmol·L-1 significantly reduced the SR Ca2+transient from perfusion solution group(100±5)%to(51± 5)%(P<0.05) and LZDO 100 μmol · L-1 failed to restore the decreased Ca2+ transient〔(49 ± 4)%〕. Normalized Ca2+transients were reduced by thapsigargin 2μmol·L-1 and thapsigargin 2μmol·L-1+LZDO 100 μmol · L-1. ④ LZDO(10 and 100 μmol · L-1)significantly increased the activities of SERCA2a in perfusion solution group 0.98±0.10 to 1.17±0.20 and (1.43±0.09)μmol Pi·g-1·h-1,respectively(P<0.05). CONCLUSION LZDO can enhance SR Ca2+ gradient by activating the SERCA2a and might be developed to serve as a potential positive inotropic agent in clinical settings.

Objective: To explore the safety and efficacy of lipoprotein apheresis (LA) in treating the patients with familial hypercholesterolemia (FH).
Methods: A total of 12 FH patients treated in our hospital from 2015-02 to 2016-10 were retrospectively studied. Based on intensive cholesterol lowering therapy with rosuvastatin (10-20) mg Qd and Ezetimibe 10 mg Qd, the patients received LA by double ifltration plasma pheresis (DFPP) via bilateral elbow central vein or femoral vein. The changes of lipid level were compared at before and after LA treatment.
Results: For pre- and immediately after LA treatment, the average total cholesterol (TC) was (9.42±3.65) mmol/L vs (2.84±0.83) mmol/L, low density lipoprotein cholesterol (LDL-C) was (7.31±3.46) mmol/L vs (1.95±0.82) mmol/L; at 1, 3, 7 and 30 days after treatment, TC and LDL-C levels showed increasing trend, while they were still lower than they were before treatment, allP<0.01. For pre- and immediately, 1 day, 3 days after treatment, the average HDL-C level was (0.96±0.31) mmol/L, (0.63±0.17) mmol/L, (0.56±0.15) mmol/L and (0.68±0.22) mmol/L respectively,P<0.05-0.01. For pre- and immediately after LA treatment, the average TG level was (1.90±0.86) mmol/L vs (0.88±0.38) mmol/L,P<0.05. Only 1 patient had the symptoms of hypotension, nausea and sweat, the patient was relieved by expectant treatment.
Conclusion: LA therapy may decrease blood levels of TC and LDL-C at short term in FH patients with good tolerance;even TC and LDL-C could slowly increase after treatment, while combining with lipid lowering therapy, it has been a safe and effective method for treating relevant patients.