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 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.

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 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 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 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

Objective To investigate the short- and mid-term outcomes of after off-pump coronary artery bypass grafting (OPCABG) in patients with severe elevation of preoperative serum creatinine levels (SEPSC). Methods The perioperative data of SEPSC patients undergoing OPCABG were investigated based on the perioperative CABG database from Feb. 2012 to Jul. 2016. The patients were also followed up for the perioperative complication, short and medium-term survival were estimated. Results The mean age of the patients was 65.4(45-85) years. The in-hospital mortality was 4.4% and the CRRT rate was 19.6%(9 case). Survival analyses revealed a survival ratio of 100% at one year, 97.6% at two years. Short-Form Mini Nutritional Assessment was used to show that 13(28.3%) patients had malnutrition. Conclusions SEPSC patients can be candidates for OPCABG procedure. The mortality in hospital and 2-year survival rate of SEPSC patients after OPCABG procedure are both considered within an acceptable range. OPCABG may be performed in these patients with a satisfactory survival rate with the development of surgical instruments and medical treatment.

Purpose To investigate the clinicopathologic features and immunophenotype as well as its association with EBV infection of lymphoepithelioma-like gastric carcinoma (LLGC). Methods The clinical pathological data were reviewed, morphological changes were observed and immunohistochemical staining was done in 6 cases of LLGC. The expression of EBV-encoded small RNA ( EBER) in the 6 cases of LLGC were carried out by in situ hybridization. Results All of the six patients were male, the age was arranged 47 to 68 years, with mean of 55 years. All of the six cases, the lesions were located in gastric body. Microscopically, the undifferentiated carcinoma cells were arranged in cords and nests, scattering in the lymphoid-rich stroma, occasionally poor development tubular struc-tures were seen in the near surface of mucosa. Lymphoid follicles could be seen with lack of fibrous tissues reaction in the tumor stro-ma. Immunohistochemical staining and in situ hybridization showed the tumor cells were diffusely positive for CKpan, CK19, CEA and EBER, but negative to CK7, CK20, CK5/6 and LMP1; interstitial lymphocytes expressed CD3 or CD20, while lost expression of EBER. Follow-up for 6-57 months, all of the 6 patients were survived without tumor. Conclusions The LLGC is a rare and unique subtype of gastric carcinoma with good prognosis, which is often associated with EBV infection.

Objective To analyze risk factors of continuous renal replacement therapy (CRRT) in patients with severe serum creatinine levels elevation undergoing off-pump coronary artery bypass grafting (OPCABG).Methods The perioperative data of 45 patients with severe elevation of preoperative serum creatinine levels undergoing OPCABG were investigated based on the perioperative CABG database from Feb, 2012 to Jul, 2016.The postoperative treatment rates of CRRT were recorded and the risk factors were identified by multivariate logistic regressions.Results There were 9 patients (20%) who suffered from CRRT after OPCABG in all 45 recruitment patients.Compared with non-CRRT patients, there were higher levels of serum creatinine (Cr) and blood urea nitrogen (BUN) before surgery, a lower volume of urine during surgery, a higher level of serum creatinine at postoperative 12 hour and 24 hour, longer ICU staying time and higher in-hospital mortality after surgery in patients with CRRT (P＜0.05 or P＜0.01).Multivariate logistic regression analysis demonstrated that preoperative level of serum creatinine (OR=1.05, 95% CI 1.05-1.10, P=0.046) was the independent risk factor of postoperative CRRT in patients with severe serum creatinine levels elevation undergoing OPCABG.At the value of postoperative 12 hour serum creatinine up to 166 μmol/L, the incidence of postoperative CRRT in patients increased 5% by postoperative 12 hour serum creatinine increasing 1 μmol/L(OR=1.05, 95% CI 1.01-1.08, P=0.013).However at the value of postoperative 12 hour serum creatinine above 350 μmol/L, ceiling effect was apparent.Conclusion This study shows that 20% patients with preoperative severe serum creatinine level elevation are suffered from CRRT after OPCABG procedure and preoperative level of serum creatinine is predominant factor of postoperative CRRT.