Adult ; Female ; Herbicides ; poisoning ; Humans ; Paraquat ; poisoning ; Poisoning ; therapy

BACKGROUND: Quiet a number of researches has reported the morphological changes of global ischemic reperfusion model. However, there are few reports on the ultrastructural changes of cortex in early reperfusion, especially the change of blood brain barrier.OBJECTIVE: To explore the changes of brain cortex neurons, glial cells and blood brain barrier in order to provide reliable evidence for clinical treatment.DESIGN: A randomized and controlled trial.SETTING: Department of Neurosurgery, Departnent of Anesthesia and Electron Microscope Room of Beijing Tiantan Hospital.MATERIALS: The experiment was conducted to 6 Wistar rats in Beijing Neurological Surgery Research Institute of Capital University of Medical Sciences during February 2003 to February 2004. The rats were randomly divided into two groups with one of ischemia-reperfusion group and sham operation group with 3 rats in each group.INTERVENTIONS: To prepare global ischemic reperfusion model of rats. Brain was removed from ischemic group in one hour of reperfusion and from sham operation group one hour after the operation. Electronic microscope technique was used to observe the ultrastructural changes of cortex.MAIN OUTCOME MEASURES: Ultrastructural changes of cortex.RESULTS: The neurons of cortex shrank to certain degree in the early stage of ischemic reperfusion(1 hour) . The glial cells were swollen with dissolved chromosome in nucleus and unclear nuclear membrane. The foot protrusions around blood vessel slightly swelled and separated from basement membrane. Mircro-tubes were partially dissolved.CONCLUSION: In early stage of reperfusion injury, the cortex neurons, glial cells, cellular framework and blood brain barrier already changed which suggested that the protective treatment such as reducing brain edema, protecting blood brain barrier should start as early as possible.

Objective To research and evaluate measuring Toric intraocular lens (Toric IOL) alignment by iTrace aberration without mydriasis.Methods Forty-five eyes of 35 patients underwent phacoemulsification in Tianjin Medical University Eye Hospital from June 2015 to February 2016 were enrolled.Follow-up and iTrace aberration examination were performed at postoperative 1 week.The internal optics aberration astigmatism axis was transformed into postoperative Toric IOL alignment.The result and the Toric IOL alignment measured by tradition slitlamp method were compared by linear correlation and difference.Results At postoperative 1 week,the uncorrected distant visual acuity and corrected distant visual acuity were (0.19 ± 0.12)LogMAR and (0.10 ±0.09) LogMAR.The UCVA was 20/40 or better in 42 eyes (93.3％).The mean IOL misalignment measured by slitlamp was (3.13 ± 2.86) degrees (ranged 0-9 degrees) and by the iTrace aberration was (4.44 ± 3.42) degrees(ranged 0-13 degrees),there was statistical significant difference (t =-2.321,P =0.025).The mean difference in the error of the Toric intraocular lens alignment measured by iTrace aberration and the slitlamp was (3.67 ± 3.59) degrees (ranged 0-14 degrees).The results showed that there was less than 5 degrees of difference between the two methods in 32 eyes (71.1％),locate 5 to 10 degrees in 9 eyes (20％),more than 10 degrees in 4 eyes (8.9％).The correlation between the 2 methods showed significant linear relationship (r =0.926,P ＜ 0.01).Conclusion Using iTrace aberration can accurately measure Toric intraocular lens alignment without mydriasis,the result has some reference value.

Objective To observe the clinical effect of abdominal Tuina and acupuncture in treating Swiss generalized anxiety disorder (GAD). Methods 80 patients of GAD caused by liver depression-qi stagnation were randomly recruited into a treatment group and a control group, 40 patients in each. The treatment group was treated with abdominal tuina & acupuncture; while the control group was treated with acupuncture exclusively. Clinical effects and hamilton anxiety scale (HAMA) score were observed in both groups before and after the treatment. Results ①There was significant difference in total efficacy between the two groups CP<0.05), and the treatment group was better than the control group. ②The HAMA score of the two groups after the treatment was lower than that before the treatment, and the difference was significant (P< 0.05). There was also significant difference of HAMA score between the two groups after the treatment (/><0.05), with the treatment group showing better results than the control group. Conclusion Abdominal tuina combined with acupuncture has sound effects in treating Swiss GAD due to liver depression-qi stagnation.

Objective To investigate the effects of smad7 on transdifferentiation and collagenⅠsynthesis in advanced glyeosylation end-products(AGE)-stimulated NRK52E cells.Methods NRK52E cells were transferred by pTet-on plasmid system and the cell lines of doxycycline(Dox)-regulated Smad7 expression were selected for the study.Transnuclear location of p-Smad2/3 was examined with immunocytochemistry.The mRNA and protein expressions of Smad7,?-SMA,E-cadherin,collagenⅠwere detected with RT-PCR and Western blot. Results AGE-induced expressions of Smad7 mRNA and protein were further increased in NRK52E cells by the addition of Dox in a dose-dependent manner.Overexpression of Smad7 caused a marked inhibition of p-Smad2/3 transnuclear location at 30 min(68.3% vs 31.2%,P

BACKGROUND: Placenta mesenchymal stem cells have become hot spots in stem cells study in recent years because of its advantages. OBJECTIVE:To analyze the biological characteristics of amniotic mesenchymal stem cells and amnion epithelial cells, and to explore the feasibility of amniotic mesenchymal stem cells and amnion epithelial cells applied as seed cells in three-dimensional liquid culture to construct the tissue-engineered skin. METHODS:The amniotic mesenchymal stem cells and amnion epithelial cells were obtained by using multi-step digestion with trypsin and col agenase;then the flow cytometry, reverse transcription-PCR and immunofluorescent staining techniques were adopted to identify the surface molecular markers, stem cellcharacteristics and keratinocytes similarity respectively. Based on these data, amniotic mesenchymal stem cells and amnion epithelial cells used as seed cells together with rat type Ⅰ col agen matrix were adopted for three-dimensional liquid culture. RESULTS AND CONCLUSION:Flow cytometry test showed that amniotic mesenchymal stem cells and amnion epithelial cells cultured in vitro could highly express CD90, CD73 and CD105, and could not express the hemopoietic stem cellmarker of CD34 and MHC-class Ⅱ molecular HLA-DR. Reverse transcription-PCR results detected that amniotic mesenchymal stem cells could express stem cellcharacteristic genes CMCY and NANOG;amnion epithelial cells could express stem cellcharacteristic genes CMCY and KLF4, showing that both amniotic mesenchymal stem cells and amnion epithelial cells have stem cellproperties. Reverse transcription-PCR results showed that amniotic mesenchymal stem cells could express keratinocytes characteristic genes K19,β1-integrin and K8;amnion epithelial cells could express K19,β1-integrin, K5 and K8. Immunofluorescence staining results showed amnion epithelial cells could express keratinocytes proliferation related protein K14, which revealed that there was certain similarity in the mRNA expression between keratinocytes and amnion epithelial cells, and indicating that it has the potential to differentiate into keratinocytes. Tissue-engineered skin was successful y constructed by using amniotic mesenchymal stem cells and amnion epithelial cells, hematoxylin-eosin staining section showed that it has certain skin structure, and amnion epithelial cells had a preliminary differentiation. Al these prove that it is feasible to construct human skin tissues with amniotic mesenchymal stem cells and amniotic epithelial cells through the three-dimensional culture.

Objective To investigate the current status and influencing factors of empowerment in peritoneal dialysis(PD) patients. Methods A total of 141 PD patients were investigated with the Peritoneal Dialysis Empowerment Scale-Short Form(PDES-SF), the Self-Efficacy for Managing Chronic Disease Scale (SEMCDS), the Self-Management Scale for Peritoneal Dialysis Patients (SMSPD), the Self-Esteem Scale (SES) and the Sense of Coherence-13 (SOC-13). Results The PDES-SF has good reliability and validity: it was positively related with the SMSPD(r=0.416,P<0.001)and the SEMCDS (r=0.465,P<0.01);Cronbach α was 0.851.The mean score of empowerment was (4.21 ± 0.54) points in PD patients. They performed poorly in making specific behavior change plans (3.95 ± 0.94) points and evaluating self management (3.99 ± 1.00) points. Multiple linear regression analysis showed that the education level, the number of PD bags, SMSPD, SEMCDS and SOC-13 were influencing factors of empowerment in PD patients (t=-2.053-6.416,P<0.05), which could explain 43.5% of the variance. Conclusions For PD patients with different education levels and PD dosages, improving the SMSPD, SEMCDS and SOC-13 can increase the empowerment.

Objective To investigate the effects of enteral nutrition support with different doses of glutamine on nutritional status and gastrointestinal function in elderly critically ill patients.Methods Totally 90 critically ill patients were randomly divided into three group:the control group without glutamine (group A),enteral nutrition with low glutamine [0.3 g/(kg· d)] (group B),and high glutamine [0.6 g/(kg· d)] groups (group C).Fasting blood samples were collected on days 1,7,and 14 after the initiation of study,and then the indicators including serum diamine oxidase,glutamine,transferin (TF),prealbumin (PA),hemoglobin (HGB),albunin,and nitrogen balance were determined.In addition,the gastrointestinal complications including bloating,diarrhea,and gastric retention were recorded.Results On the 7th and 14th days,the serum glutamine levels in groups B and C were (1 886.8 ±420.5),(2 228.6 ±440.2) μg/L;(1 889.6 ± 436.1),(2 174.3 ± 440.8) μg/L,respectively,which were significantly higher than those in group A [(1 612.0 ±493.5),(1 869.7 ±559.8) μg/L] (P =0.027,P =0.008).The serum diamine oxidase levels were also significantly lower in group B [(2 310 ± 1 271),(1 602.5 ± 1 137.9) U/L] and group C [(2 076.3 ±567),(1 586.3 ±530.9) U/L] than in group A [(3 250 ±923),(2 476 ±862) U/L] (P =0.000,P =0.000).The serum TF and PA levels were significantly increased on the 7th day (P =0.023,P =0.047),and the HGB was significantly higher on 14th day (P =0.003),The number of patients who had undergone successful implementation of enteral nutrition were 4 and 3 in groups B and C,and the number of patients who had achieved the target volume of enterral nutrition was 25 and 27 in groups B and C,which were significantly larger than those in group A (12 and 13,respectively) (P =0.008,P =0.000).The gastrointestinal complication was also significantly decreased after the administration of enterral nutrition with glutamine.Conclusions Enteral nutrition with glutamine can improve intestinal mueosa barrier and nutritional status in elderly critically ill patients.Thus,it helps to reduce gastrointestinal complications and transition time of total enteral nutrition.

Objective To analyze the causes of blood deficiency in the process of voluntary blood donation and to adopt targeted control measures,so as to effectively reduce blood scrapping and to better ensure theclinical blood use of the hospital.Methods The data of blood collection from January 2014 to December 2016 and the various reasons of insufficient blood collection were summarized;and according to these data as the object of study,the targeted measures were taken to observe the effect.Results According to the the reasons for the lack of blood collection,the targeted measures,such as organizing staff training,strengthening communication with blood donors and so on,were taken.After the implementation of these measures,the phenomenon of insufficient blood collection from 2014 to 2016 showed declining trend,withthe proportion decreased from 0.29％ to 0.20％.Conclusion To strengthen the staff staining in order to improve them vein collection technology,to publicize further,to communicate with blood donors effectively and improve the blood donation services,to ease the feelings of blood donors and to create a warm,harmonious and orderly blood donation atmosphere;all of these should be helpful for reducing the occurrence of insufficient blood collection.

Background Retinal photocoagulation iconsidered to be an effective therapy fodiabetiretinopathy (DR).Fundufluorescein angiography (FFA) iused to determine if panretinal photocoagulation (PRP) ineeded.SometimeFFiunsuitable fosome Dpatients,and funduphotography igenerally applied.However,whethecolofunduphotography can substitute foFFin evaluating Dgrading and advising foadministering the photocoagulation protocol iunclear.Objective Thistudy wato compare the grading outcomebetween colofunduphotography and FFin assessing DR.Methodprospective case serieself-controlled study wadesigned.Thiclinical study waapproved by the EthiCommittee of Shanghai Tenth People'Hospital,and written informed consenwaobtained from each patienprioto entering the series.Five 50° non-stereoscopiphotographwere taken in 238 eyeof 136 patientwho methe criteriof type 2 diabetes,and then the FFwaperformed.The imagewere analyzed based on the 2003 International DiabetiRetinopathy Disease Severity Scale.The comparison of the grading outcomein assessing Dbetween colofunduphotography and FFwaevaluated by the Kappagreementesusing SPS17.0.ResultFunduphotography showed mild non-proliferative D(NPDR) in 17.2％ of case(41/238),moderate NPDin 20.2％ of case(48/238),severe NPDin 27.7％ of case(66/238) and PDeyein 34.9％ of case(83/238).FFshowed mild NPDin 20.2％ of case(48/238),moderate NPDin 17.6％ of case(42/238),severe NPDin 19.3％ of case(46/238) and PDin 42.9％ of case(102/238).The concordance foDgrading between funduphotography and FFwasubstantial (κ =0.653,P＜0.01).In evaluating whetheiwanecessary to administePRP (to severe NPDand PDpatients),good concurrence waobserved between funduphotography and FF(κ=0.812,P＜0.01).ConclusionThe merge image from five 50° non-stereoscopiphotographpresentagood indicatofothe selection of PRP in Dpatientwith type 2 diabetes.However,the physicianshould be cautiouin the evaluation of retinal non-perfusion areand neovascularization by funduphotography.