Objective:To study the importance of nursing cooperation in 16-slice spiral CT contrast enhancement scanning,so as to ensure scanning effect and reduce side reaction.Methods:Clinical records of 2 860 cases underwent 16-slice spiral CT contrast enhancement scanning were analyzed retrospectively.Preparation was done well;patients` reactions were closely observed during scanning;and treatment was performed basing on based on patients` condition.Results:Ninety-three per cent(2 660 in 2 860) of cases presented transient sensation of heat all over the body after injection of non-ion contrast agent;120 cases(4.2%) presented sensation of heat all over the body,bitter taste and itching on perineal region;35 cases(1.2%) presented slight allergic reactions such as sensation of heat all over the body,skin itching,nausea,and urticaria;9 cases presented moderate allergic reactions such as sensation of heat all over the body,urticaria,nausea,vomiting,palpitation,and dyspnea;leakage in pricking region was found in 5 cases(0.1%);none presented severe allergic reaction;and no nursing complications such as skin necrosis and air embolism appeared.Conclusion:Good preparation of nursing care could ensure the effect of contrast enhancement scanning,improve accuracy of diagnosis,and reduce or even avoid allergic reactions.

BACKGROUND: Both apoptosis suppression gene Bcl-2 and apoptosis in duction gene Bax take parts in the apoptosis of neurons in ischemic penum bra. Whether would the polypeptide from chlamys farreri that is proved to be of anti-oxidation and anti-apoptosis in vitro protect the ischemic neurons from apoptosis? OBJECTIVE: To observe the effect of chlamys farreri on the Bcl-2 and Bax protein-associated apoptosis in penumbra and its role in neuron protection. DESIGN: A randomized trial.SETTING: Department of Anatomy, Medical College of Qingdao University.MATERIALS: The trial was conducted in Nerve Anatomy Laboratory of Medical College of Qingdao University from March to April 2000. The subjects were 32 adult Wistar rats that were randomly and averagely assigned into 4 groups: polypeptide chlamys farreri group, sterile water group, model control group and sham group. The chlamys farreri was provided by the Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences.INTERVENTIONS: Model of brain ischemia and reperfusion was made in rats in polypeptide chlamys farreri, sterile water and model control group by occlusion of middle cerebral artery. The model was not established in rats in sham group. The rats in chlamys farreri group received intraperitoneal injection of chlamys farreri of volume fraction 0. 1 at the dose of 0. 1 mL/kg each day for 2 days prior to modeling and an extra injection 15 minutes just before modeling. And the rats in sterile water group received intraperitoneal injec tion of sterile water with the dose of 0. 1 mL/kg each for two days and an extra injection 15 minutes before modeling. Those in model control group and sham group were exposed to nothing. Then models were established in rats in chlamys farreri, sterile water and model control group by inserting 4-0 nylons sutures from external carotid artery through bifurcation of carotid artery,extracranial and intracranial segments of internal carotid artery till the initial part of middle cerebral artery to make acute ischemia of middle cerebral artery perfusion area. The model was considered successful by the presentation of Horner' s syndrome, adduction-flexion of right forearm when tail being lifted and right turning during walk of the rat. The rats in sham group underwent the same procedures as that in the other groups except for the occlusion of middle cerebral artery. Then brains of the rats were taken for immunohistochemical determination of Bcl-2 and Bax proteins. The protein expression was expressed by absorbance of the products of their immunological reaction.MAIN OUTCOME MEASURES: The expression differences betweenBcl-2 and Bax proteins in penumbras of the groups.RESULTS: There were 32 rats entered the stage of analysis after complement of subjects. ① Bcl-2 expression in penumbra: The absorbance in model control group and sterile water group were higher than that in sham group (0.453±0.048,0.510±0.061,0.211±0.023, F=683.78, q=21.13 to 24.74, P ＜ 0.01), and that in chlamys farreri group(0. 954 ±0. 059) was more than that in model control group and sterile water group( q = 38.08 to 41.69, P ＜ 0.01) . ② Bax expression in penumbra: The absorbance in model control group and sterile water group were higher than that in sham group (0. 834 ±0. 082, 0. 790 ±0. 102, 0. 125 ±0. 017, F=590.44, q =49.57 to 51.98, P ＜ 0.01 ) ] and that in chlamys farreri group (0.471 ± 0. 045 ) was suppressed as compared with that in model control group and sterile water group(q=23. 80 to 26. 23, P ＜0. 01).CONCLUSION: Chlamys farreri is capable of increasing Bcl-2 protein and decreasing Bax protein in cerebral penumbra to brake the initiation of neuron apoptosis after ischemia-reperfusion and preserve neuronic function in penumbra.

Objectives To determine the serum levels of high mobility group box-1 protein ( HMGB1 )in patients with acute pancreatitis (AP) and to investigate the contributions of HMGB1 in the pathogenesis of AP. Methods The serum HMGB1 concentrations were determined by enzyme-linked immunosorbent assay in 33 patients with severe acute pancreatitis (SAP), 38 patients with mild acute pancreatitis (MAP) and 28 healthy controls at the time of admission within 72 h after the onset. THe relationships between the serum HMGB1 levels and sex, age, etiology, disease onset, Ranson score, Balthazar CT score, C-reactive protein,lactate dehydrogenase and serum creatinine, total bilirubin levels, local and systematic complications were analized. Results The serum HMGB1 levels in healthy control group, MAP group and SAP group were ( 1.82 ±0.64)μg/L, (6. 13 ±5.80) μg/L and (11.48 ±6.94)μg/L, respectively. The mean value of serum HMGB1 level in MAP group was significantly higher than that in healthy group ( P < 0. 05 ), while it was significantly lower than that in SAP group ( P <0.05 ). Within 24 h after disease onset, the serum levels of HMGB1 began to increase, and reached the peak at 48 h, then decreased and remained higher than normal value at 72 h.There were no remarkable relationships between the serum HMGB1 levels and sex, age, etiology, but it was positively correlated with Ranson score, Balthazar CT score, C-reactive protein, lactate dehydrogenase and serum crkatinine. The serum levels of HMGB 1 in patients with local and / or systematic complications were higher than those in patients without complications, but the difference was not statistically significant.Conclusions HMGB1 is a late inflammation mediator and serum HMGB1 levels were correlated with the severity of AP. HMGB1 may participate in the development of acute renal insufficiency during SAP.

Oblective To define the median effective dose (ED50) and 95%effective dose of fentanyl for inhibition of emergence agitation after sevoflurane-remifentanil anesthesia in children.Methods Twenty six ASA ⅠorⅡchildren aged 5-8 yr weighing 15-30 kg undergoing adenoidectomy under general anesthesia were studied.The patients were unpremedicated.Anesthesia was induced with inhalation of 8%sevoflurane (fresh gas flow=6 L/min)and iv remifentanil 1μg/kg.The patients were mechanically ventilated after tracheal intubation.Fentanyl was injected iv to inhibit emergence agitation.The dose of fentanyl was determined by using modified Dixon's upand-down method (increment or decrement of 0.5μg/kg).The initial dose of fentanyl was 4 μg/kg.Anesthesia Sevoflurane inhalation and remifentanil infusion were terminated at the end of operation.The patients were transferred to the PACU.No alteration in the ventilatory settings was made.Stimulation of the patients was avoided during emergence.The emergence time and the occurrence of agitation,nausea and vomiting and respiratory depression within 4h after operation were recorded.ED50,ED95 and 95%confidence interval (CI) of fentanyl for inhibition of emergence agitation were calculated.Results ED50 was 3.01μg/kg (95%CI 2.52-3.40μg/kg) and ED95 3.81μg/kg(95%CI 3.41-6.22μg/kg).No nsusea and vomiting and respiratory depression occurred within 4h after operation.The emergence time was (11.3±2.6) min.Conclusion The ED50 and ED95 of fentanyl for inhibition of emergence agitation after sevoflurane-remifentanyl anesthesia were 3.01 and 3.81μg/kg respectively in children.

Objective To investigate the effects of gallotannic acid, the alcohol extract of Galla chinensis, the alcohol extract of Flos carthami and the water extract of Aloe vera on normal human keratinocytes, melanocytes and fibroblasts in vitro, and get a better understanding of the mechanism of action and the possible adverse effects of Galla chinensis in treating keloid. Methods MTT colorimetric assay was used to detect the effects of gallotannin, colchicine and the later two extracts on the growth activity of the different cells. Results ①The inhibitory action of gallotannin to fibroblasts proliferation was similar to that of the alcoholic extract of Galla chinensis, and the inhibitory action of gallotannin at ≥ 20 ?g/mL to the proliferation of melanocytes was obvious (the proliferation rate was 73.6% - 68% of untreated cells), while gallotannin at ≤ 50 ?g/mL slightly enhanced the growth activity of keratinocytes (the proliferation rate was 111% - 112% of untreated cells). ②Both the alcoholic extract of Flos carthami and the water extract of Aloe vera enhanced the proliferation of keratinocytes in a dose-dependent mode. The water extract of Aloe vera also enhanced the proliferation of fibroblasts. Conclusions The gallotannin may be the main pharmacologically active component of Galla Chinensis for treating keloid, and its inhibitory activity to human melanocytes may implicate its potential adverse effects on the skin.

Object To study the feasibility of flocculation procedure on Bushenhuoxue Decoction, using chitosan instead of alcohol. Methods Using chitosan clarifier to the flocculation procedure of Bushenhuoxue Decoction; selecting the optimum content of chitosan and the density of decoction according to the total extract, and the content of icariin, comparing with the flocculation procedure by alcohol sedimentation. Results Chitosan clarifier could make the decoction clarify as alcohol does. On the retaining of active compounds, the former was better than the later. Conclusion Chitosan can be used to the flocculation procedure of Bushenhuoxue Decoction instead of alcohol.

Chorionic Villi ; metabolism ; pathology ; ultrastructure ; Diabetes, Gestational ; metabolism ; pathology ; Female ; Glucose ; metabolism ; Glycogen ; metabolism ; Humans ; Lipids ; analysis ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Placenta ; metabolism ; pathology ; ultrastructure ; Pregnancy

Objective To explore the value of serum level of interleukin 6 (IL-6),tumor necrosis factor alpha (TNF-α) and high mobility group box-1 protein( HMGB1) in early assessment the severity and prognosis of acute pancreatitis (AP). Methods Thirty-three severe acute pancreatitis (SAP) patients and 38 mild acute pancreatitis (MAP) patients were selected as study objects;and 51healthy individuals were set as control group. Serum IL-6,TNF-α and HMGB1 concentrations were determined by enzyme-linked immunosorbent assay (ELISA),the association of them and the scores of Ranson,APACHE Ⅱ . Balthazar CT,serum biochemical parameters and prognosis was analyzed.Results The serum IL-6 levels of SAP group,MAP group and healthy control group were (553. 72±175.76) pg/ml,(265. 73±179. 95) pg/ml and (16. 43±3. 32) pg/ml;and there were statistical significance of these three groups (all P＜0. 01). There was no significant difference of TNF-α in the three groups (all P＞0. 05). The serum HMGB1 levels of SAP group,MAP group and healthy control group were (11. 48±6. 94)μg/L,(6. 13±5. 80)μg/L and (1. 82±0. 64)μg/L respectively,and there were statistical significant of these three groups (all P＜0. 05). The correlation coefficient of serum HMGB1 with IL-6 and TNF-α were 0. 896 and 0. 724 (P＜0. 01) respectively. The IL-6 level was positively correlated with the scores of Ranson,APACHE Ⅱ and Balthazar CT. The TNF-αconcentration was positively correlated with APACHE Ⅱ score,and the HMGB1 concentration positively correlated with scores of Ranson and Balthazar CT. The levels of IL-6,TNF-α and HMGB1were all positively correlated with the serum creatinine concentration. The IL-6 levels of patients with local and/or systemic complications were significantly higher than those without complications.Conclusion The serum levels of IL-6,TNF-α and HMGB1 are significantly correlated with the severity of pancreatitis,all of them take part in the development of acute renal insufficiency. The high level of serum IL-6 significantly correlated with complications.