Objective To investigate the clinical significance of central venous oxygen saturation (ScvO2) monitoring in the patients after cardiac operation.Methods Fifty patients after cardiac operation were randomly selected into this study.After the patients entered ICU 2 h,ScvO2,mixed venous oxygen saturation (S(v)vO2),lactate (Lac) were detected at the same time and oxygen extraction rate (O2ER) was calculated.Fifty patients were divided into three groups according to the level of ScvO2,group A (ScvO2 ＜0.65,23 patients),group B (ScvO2 0.65-0.75,18 patients),group C (ScvO2 ＞ 0.75,9 patients).The correlation among ScvO2,S(v)vO2,O2ER were analyzed.The correlation between ScvO2 and Lac in each group were calculated.The level of Lac in three groups were compared.The incidence rate of complications,ventilator time and ICU stay time were compared.Results The level of ScvO2,S（v）O2,O2ER,Lac in 50patients were 0.656 ±0.086,0.639 ±0.081,0.356 ±0.084,(2.6 ± 1.3) mmol/L.The level of ScvO2 had significantly positive correlation with S(v)O2 (r =0.688,P ＜ 0.01),and had significantly negative correlation with O2ER (r =-0.640,P ＜0.01).In group A,the level of Lac had significantly negative correlation with ScvO2 (r =-0.772,P ＜ 0.01).In group C,the level of Lac had significantly positive correlation with ScvO2 (r =0.717,P ＜ 0.05).In group B,the level of Lac had no significant correlation with ScvO2 (r =-0.358,P ＞0.05).The level of Lac in group A and group C was significantly higher than that in group B [(2.0 ± 0.9),(4.8 ±2.1) mmol/L vs.(1.6 ±0.5) mmol/L] (P ＜0.05 or ＜0.01).The incidence rate of hyoxemia,low cardiac output syndrome and renal functional lesion in group A were significantly higher than those in group B (P ＜ 0.05).The incidence rate of liver functional lesion and renal functional lesion in group C were significantly higher than those in group B (P ＜ 0.05).The ventilator time and ICU stay time in group A andgroup C were significantly longer than those in group B (P ＜ 0.05).Conclusions ScvO2 is an ideal index to judge oxygen equilibrium in early period after cardiac operation.The lower and supranormal ScvO2 both suggest tissue hypoxia,resulting in increased postoperative complications and prolonged treatment.

With the transformation of medical model,technical improvement,and the development of various medical laws and regulations,requirement for medical ethics is being increased in clinical medical education gradually.Under this circumstance,medical simulation education come into being and evolves prosperously.However,present application of medical simulation education is imperfect and far from satisfaction in China.This article summarizes the relation of medical ethics and medical simulation education.

AIM To examine the effects of the APP17-mer peptide against A? 25-35 -induced apoptosis and gain some insight into the neuroprotective mechanism of the APP17-mer peptide. METHODS Protective effects of APP17-mer peptide against A? 25-35 -induced apoptosis in SH-SY5Y cell was proved by cell morphology, LM-PCR DNA ladder assay and FCM assay. The antiapoptotic mechanism of APP17-mer peptide was investigated using the MTT assay to measure mitochondrial energy redox state, using the fluorescent probe DCF-DA?Rhodamine 123 to measure relative levels of cellular peroxides and mitochondrial membrane potential and using Western blot for AIF and NF-?B to detect the expression of AIF and NF-?B. RESULTS Damage of cell morphology was ameliorated by pretreating with APP17-mer peptide. The apoptotic rate of the SH-SY5Y cells exposed to A? 25-35 in the presence of APP17-mer peptide decreased from 63.75% to 28.25%. Exposure of SH-SY5Y to A? 25-35 for 48 h resulted in an increase in DCF-DA fluorescence,a decrease in Rhodamine 123 fluorescence and MTT reduction, the results were weakened by pre-incubating with APP17-mer peptide for 30 minutes. Treatment of cells with APP17-mer peptide resulted in a significant attenuation in the expression of AIF and a strong increase in the expression of NF-?B. CONCLUSION APP17-mer is protective against cell apoptosis induced by A? 25-35 by provoking and sustaining upregulation of a key antiapoptotic transcription factor NF-?B, by suppressing oxyradical production and by preserving mitochondrial function and inhibiting the release of apoptotic protein from mitochondria.

Objective: To detect the expression of basic fibroblast growth factor(bFGF), type Ⅲ collagen(Ⅲ-col)and fibronectin(FN) in human dental pulp at different root development stages of permanent teeth. Methods: 10 teeth at stage Ri～R 1/4 ,15 at R 1/3 ～R 3/ 4 and 12 at Rc～Ac were sectioned for following examination.bFGF, Ⅲ-col and F N were qualitatively and quantitatively analyzed by the use of immunohistologica l SP method and image analysis technique. Results: The ex pression of bFGF became gradually weaker and weaker with the development of too th root (P

Objective To establish a three-dimensional finite element model of thoracolumbar fractures treated by mono-segmental instrumentation in the fractured part for testing effect of such fixation mode on adjacent segments.Methods CT scanning data of T10-L2 were used to build a normal model at T10-L2 region,a fracture model at T12 segment as well as a mono-segment fixation or short-segment fixation model.Stress of discs and vertebral body adjacent to the fixed vertebrae were tested in axial compression,anteflexion,extention,lateroflexion,and axial rotation.Results The fracture model presented significant increase concerning stress of nucleus pulposus and annular fibrosus at T10-T11 segments and annular fibrosus at L1-L2 segments in anteflexion,extention,and lateroflexion when compared with the normal model.General raise range of the stress reached around 75％,but was dropped to 23％ after short-segment fixation and to 18％ after mono-segmental fixation.And again,stress of nucleus pulposus at L1-L2 segments was increased by 46％ or so,which was declined to 12％ after short-segment fixation and to 8％ after mono-segmental fixation.Stress at lower endplate of T10 and at upper endplate of L2 in the fracture model group were increased by 24％ and 43％ respectively when compared to the normal model,but both presented a notable drop after internal fixation.The latter was decreased to a level slightly higher than that of model group,namely 8％ more after short-segmental fixation and 4％ more after mono-segmental fixation; the former was decreased to a level even lower than that of control group,namely 2％ less after short-segmental fixation and 8％ less after mono-segmental fixation.Conclusion Mono-segmental fixation reduces adjacent disc stress in contrast to conventional short-segmental fixation and hence is an effective alternative treatment of monosegmental thoracolumbar fractures.

[Objective] To evaluate the significance of plasma endothelin in tubal pregnancy (TP) and to observe the regulatory effect of kidney-reinforcing, blood-activating and blood-stasis-removing Chinese herbal medicine on endothelin (ET) level. [Methods] Plasma ET level and ET-positive rate were detected in 40 cases of TP, 20 of intrauterinc pregnancy (IP) and 20 of chronic pelvic inflammation (CPF) and the relationship between the two above indexes in the patients were analyzed. TP patients were randomized to three groups; group A (n = 15) was treated with No. 1 Yishen Huoxue Pills (6g, tid) and Penyankang mixture (25mL, tid) for two treatment courses; group B (n = 15) was treated with aspirin (257ng, qd) for two treatment courses; group C ( n - 10) was not given any medicines. [Results] ET-positive rate and plasma ET level in postoperative TP patients were higher than those in IP patients ( P .05) . Chinese herbal medicine could decrease ET-positive rate and plasma ET level in postoperative TP patients (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 mechanism of antioxygen reaction of epigallocatechin-3-gallate (EGCG) in renal tubular epithelial cells of rats with oxidative stress induced by H2O2. Methods Cultured cells were divided into control group, H2O2 group and EGCG group. Cell survival was observed with MTT. The expressions of Nrf2 mRNA and -γ-GCS mRNA in cultured cells were examined by real time quantitative PCR. Immunohistochemistry and western blotting were used to detecte the expressions of Nrf2 and γ-GCS protein. Results The survival rate of tubular cells was 97. 61 ± 6.33 in control group. There was a significant decrease in H2 O2 group (56. 38 ± 5.57) (P < 0.01), while increased when the EGCG concentration were 5,10,20 mg/L(77.42 ±5.31,83.27 ±5.94,90.24 ±5.72) (P <0.05,P <0.01). EGCG up-regulated the expressions of Nrf2 and γ-GCS mRNA and protein in renal tubular epithelial cells with dose depen-dentment. Conclusion The expressions of Nrf2 and-γ-GCS increase in renal tubular epithelial cells with oxidative stress. Resulting from suppression of oxidative stress,EGCG exerts protective effect on NRK,and this antioxidative effect may be partly induced by activating the Nrf2 signal pathway.

Objective To evaluate the association of gastric hyperplastic polyps with colorectal neo-plasia.Methods Data of consecutive patients who underwent esophagogastroduodenoscopy (EGD)and colonoscopy between January 2011 and December 2013 were reviewed retrospectively.They were compared with patients without gastric polyps who also underwent EGD in the same period.The relationship between gastric polyps and colorectal neoplasia was analyzed.Results The incidence of colorectal neoplasia in gas-tric hyperplastic polyps group was higher than that of the control group [24.0% (46 /192)VS 10.4%(40 /384),P =0.000].An increased incidence of colorectal adenomas in gastric hyperplastic polyps group was found,but there was no difference in the incidence of colorectal cancer in gastric hyperplastic polyps group and control group[2.1%(4 /192)VS 2.3%(9 /384),P =1.000].Stratification analysis suggested that the incidence of colorectal neoplasia in gastric hyperplastic polyps group who aged over 50 was signifi-cantly higher than that in the control group[28.5%(43 /151)VS 10.6%(29 /274),P =0.017],regard-less of different genders and the number of gastric hyperplastic polyps.Conclusion The incidence of color-ectal neoplasia in gastric hyperplastic polyps has significantly increased,especially in those aged over 50 years,regardless of different genders and the number of gastric hyperplastic polyps.Such patients should undergo colonoscopy to detect colorectal neoplasia.

Objective To explore the prognostic value of N-terminal pro-brain natriuretic peptide ( NT-pro-BNP) levels in critically ill infants. Methods Eighty-one critically ill infants were enrolled from January 2013 to January 2014 in pediatric intensive care unit. The minimum of pediatric critical illness score ( PCIS) and the number of dysfunction organs were calculated within 24 hour after admission. According to PCIS,the critically ill infants were divided into extremely critical group(PCIS≤70,n=25),critical group (PCIS 71-80,n=30)and non-critical group(PCIS>80,n=26). According to the prognosis,the critically ill infants were divided into survival group (n=68)and death group(n=13). The serum NT-pro-BNP levels were determined on the first day,third day and convalescent phase. The relationships of serum NT-pro-BNP levels with PCIS and the number of dysfunction organs and prognosis were observed. Results The study showed statistical significances of serum NT-pro-BNP levels among the extremely critical group, critical group and non-critical group,whether on the first day,or on the third day and convalescent phase(P<0. 01). There were statistical significances of serum NT-pro-BNP levels among different stages of the disease in each group(P<0. 01). Compared with survival group,PCIS was significantly lower and the serum NT-pro-BNP levels and the number of dysfunction organs were significantly higher in death group. The serum NT-pro-BNP level on the third day was higher than that on the first day in death group ( P<0. 01 ) , while no significant difference was found in survival group. The serum NT-pro-BNP levels on the first day and the third day and PCIS were negatively correlated(r= -0. 59,P<0. 01;r= -0. 66,P<0. 01). The serum NT-pro-BNP levels on the first day and the third day and the number of dysfunction organs were positively correlated(r=0. 40,P<0. 05;r=0. 57,P<0. 01). Conclusion The serum NT-pro-BNP levels of the critically ill infants are correlated with disease severity,and can be useful for assessing the severity of critical illness.