Objective There are two main functions of gastrointestinal tract,digestion and absorption,and barrier function.The latter has an important defensive effect,which keeps the body away from the invading and damaging of bacteria and endotoxin.It maintains the systemic homeostasis.Intestinal dysfunction would happen when body suffers from diseases or harmful stimulations.The more serious intestinal disorders would harm the intestinal protective mechanism,or intestinal barrier function,and bacterial/endotoxin translocation,of intestinal failure(IF) would ensue.This article provides a critical review of the evidence indicating that an increase in bacterial translocation is associated with sepsis,and even the multiple organ failure syndrome in critically ill patients.The in-transit microorganisms play an essential role in the homeostasis of local and systemic immunity.Methods All studies published from 2000 to June 2005 about intestinal permeability,bacterial translocation,and systemic inflammatory response syndrome were located by search of PubMed.Results Clinical and experimental studies investigating the correlation between bacterial translocation and systemic inflammatory response syndrome,associated with the damage of the gut barrier function.To keep the mucosal barrier function intact is one of the main issues in the prevention of bacterial translocation.This could be achieved by the adequate delivery of oxygen and nutrient supplementation to the gut.Enteral nutrition,probiotic can be a good choice.Conclusion With a better understanding of the bacteria-host interactions in health and the alterations induced by critical illness,new therapies that improve the environment of both may lead to better recovery rates in intensive care unit patients.

Adult ; Echinococcosis ; Heart Diseases ; parasitology ; Humans ; Male

Objective To analyze the accuracy,repeatability and feasibility of Ultrafast Doppler for renal artery ultrasonography.Methods One hundred and one cases were selected that were suspected to have renal artery disease and were successful of conventional and Ultrafast Doppler for renal artery ultrasonography,and 101 cases were grouped by age (≤40 years old,41-60 years old,≥61 years old),body mass index (BMI) (normal 18.5-23.9 kg/m2,overweight 24.0-27.9 kg/m2,obesity ≥28.0kg/m2) and whether there were the presence of renal artery stenosis (no significant renal artery stenosis and renal artery stenosis ＞60％).Each case was respectively examined by conventional and Ultrafast Doppler for renal artery ultrasonography in a random order.The consistency of Doppler parameters was tested.The duration of each Doppler study was compared and the feasibility of Ultrafast Doppler for renal artery ultrasonography was explored.The Doppler parameters included:renal artery peak systolic velocity (PSV),resistance index (RI),renal segmental artery acceleration time (T) and time consuming (△T).The concordence and △T of two Doppler method were compared.Results ① Ultrafast Doppler had good reproducibility,intraclass correlation coefficient (ICC) values were ＞ 0.6.② For renal artery ultrasonography,the successful number of cases examined by Ultrafast Doppler were more than those examined by conventional Doppler,but the difference was not statistically significant (P ＞0.05).③The Doppler parameters from all subjects and different groups showed a strong positive correlation between the two Doppler studies (P ＜0.05).④ UltraFast Doppler required a shorter time than conventional Doppler (P ＜0.05).⑤The △T of cases with different ages and with or without renal artery stenosis showed no statistically significant (P ＞0.05),however,their △T were increased with body mass index increasing (P＜0.05).Conclusions Ultrafast Doppler for renal artery ultrasonography has a high success rate,a good repeatability and consistency,and a shorter time consuming and simple operation than conventional Doppler.

BACKGROUND:The strength of al-ceramic crowns is affected by many factors. At present there are many studies concerning the neck edge shape, cutting thickness, binder and convergence angle, but little has been reported on the effects of different occlusions on al-ceramic crowns. OBJECTIVE:To explore the maxilary central incisor al-ceramic crowns in different occlusal states by finite element analysis. METHODS: Three-dimensional finite element models of the maxilary central incisor al-ceramic crowns were established. Empress II and In-Ceram Zirconia were selected. The normal overbite position and deep overbite position were applied to force a load of 230 N, with the long axis of the tooth at a 45° angle. Distribution of inner stress and edge stress was analyzed at different occlusal states. RESULTS AND CONCLUSION:(1) The stress distribution of al-ceramic crowns under different occlusion relationship was different. The stress peaks of cementum, alveolar bone and periodontium in the deep overbite were lower than those in the normal overbite. The stress peaks of al-ceramic crowns and binder were higher than in the deep overbite than the normal overbite. The stress peak of the dentin in the Empress II group was higher in the deep overbite than in the normal overbite. The stress peak of the dentin in the In-Ceram Zirconia group was lower in the deep overbite than in the normal overbite. Different al-ceramic crowns had no influence on the stress distribution, but in the deep overbite, the stress was mainly concentrated in the occlusal contact area, and in the normal overbite, the stress was mainly concentrated in the occlusal contact area and at the labial cervical margin. (2) The stress distribution of different al-ceramic crowns under the same occlusal state was different. In the normal overbite, different al-ceramic crowns had no evident influence on the stress peak, and in the deep overbite, there was a certain effect of different al-ceramic crowns on the stress peak, but there was no significant difference. The stress peaks of blinder and dentin were obviously affected by al-ceramic crowns. The stress peaks of blinder and dentin in Empress II group were higher than those in the In-Ceram Zirconia group.

Objective To evaluate the performance of virtual touch tissue quantification imaging (VTQ) for differential diagnosing in uterine hysteromyoma and adenomyoma. Methods Blood flow parameters and SWV (shear wave velocities) from 42 regular hysteromyomas,14 abnormal hysteromyomas and 25 uterine adenomyomas were compared and analyzed through color Doppler. Results The SWV of regular hysteromyomas was on average of (2.72 ± 0.31) m/s;that of abnormal hysteromyomas (1.88 ± 0.25) m/s;while the SWV of uterine adenomyomas was on average of 1.91 ± 0.27 m/s. The mean SWV in regular hysteromyomas group was significantly higher than that in abnormal hysteromyomas group and uterine adenomyomas group (P < 0.05). There was no significant difference of SWV between abnormal hysteromyomas group and uterine adenomyomas group (P > 0.05).The resistance index and SWV of uterine hysteromyomas and adenomyomas had positive correlation (r = 0.753,0.544,0.506,P < 0.05). Conclusion VTQ can quantify the stiffiness of uterine hysteromyoma and adenomyoma.

Humans ; Vertigo ; diagnosis ; physiopathology ; Vestibular Evoked Myogenic Potentials

ObjectiveTo assess the microscopic features of alopecia areata(AA) by using in vivo confocal laser scanning microscopy(CLSM).MethodsBetween January 2010 and May 2011,26 male and 20 female patients diagnosed with AA were enrolled in this study.AA lesions and perilesional normal skin were examined by means of in vivo CLSM.Tissue specimens were obtained from the lesions and perilesional normal skin of 10 out of the 46 patients and subjected to routine histopathologic examination.ResultsThe number of hair follicles per unit area(cm2) was decreased in lesions of progressive AA and resting AA compared with normal perilesional skin(134.856 ± 18.301 and 147.159 ± 17.536 vs.301.613 ± 35.317,both P ＜ 0.05).Although the quantity of hair follicles increased in lesions of recovery AA((227.778 ± 16.861 )/cm2),but was still less than that in the normal perilesional skin (P ＜ 0.05).There was a lack of hair shaft in follicles,as well as an inflammatory infiltration in hair follicles,around hair follicles and capillaries in superficial dermis in lesions of progressive AA.The inflammatory infiltration was attenuated in lesions of resting AA.In lesions of recovery AA,the infiltration was further attenuated with an apparent growth of lanugos and terminal hairs.ConclusionsAs far as AA lesions are concerned,CLSM images are consistent with histopathological findings.CLSM may serve as a promising tool for monitoring efficacy and predicting prognosis based on hair growth cycle,hair follicle number,and inflammatory infiltration degree.

Objective To evaluate the accuracy and clinical practicality of DNA chip in comparison with serology in typing of human leukocyte antigen A (HLA-A) in Han's individuals of donor-recipients of transplantation. Methods 120 peripheral blood samples were obtained from donor-recipients of transplantation. Each sample was divided into two parts and HLA-A antigens were identified by DNA chip in one part and by serology in another. Samples in which the HLA-A typing results by these 2 methods were discordant were verified by polymerase chain reaction with sequence specific primers (PCR-SSP). Accuracy and clinical practicability of both methods were compared according to the typing results. Results Serological typing for HLA-A took 3 h, while DNA chip typing 4. 5-5 h. 112 samples have been typed successfully. Typing results were same in 91 samples and discordant in 21 cases. The verified results showed that DNA chip made 2 incorrect typing and the error rate was 2%. Meanwhile, serology made 19 mistakes, consisting of 5 antigens being incorrectly interpreted and 14 "blanks" turning out to be definable alleles. The discrepancy rate was 17 %. Conclusions DNA chip typing for HLA-A is suitable for clinical application in Chinese Han's population with a greater precision than serology. It may replace the serology in future after being improved and perfected.

Objective To explore the correlation of the apoptosis of peripheral blood mononuclear cell (PBMC) with plasma 8-iso-prostaglandin F2? (8-iso-PGF2?) level in order to confirm the peroxidation damage of hyperbilirubinemia in neonates with jaundice.Me-thods One hundred and twenty-nine neonates who were 2 to 7 days old were divided into 4 groups:slight jaundice (43 cases),moderate jaundice (38 cases),serious jaundice (18 cases),and healthy control(30 cases)groups.Plasma 8-iso-PGF2? levels were assayed by enzyme immunoassay(EIA),and the apoptosis rates of PBMC were determined by flow cytometry.Results 1.There was no significant difference in the apoptosis rate of PBMC between normal and slight jaundice neonates (P=0.108);apoptosis rate of PBMC was increasing with the aggravation of jaundice.2.Plasma 8-iso-PGF2? level in normal neonates was 14.74?6.71 ng/L,there was no difference between normal neonates and neonates with slight jaundice(P=0.502).Plasma 8-iso-PGF2? levels in neonates with moderate and serious jaundice were much higher(Pa=0).3.Positive correlation existed between plasma 8-iso-PGF2? level and PBMC apoptosis rate (r=0.602 P=0).Conclusions Hyperbilirubinemia can induce peroxidation damage,resulting in increase of PBMC apoptosis.Plasma 8-iso-PGF2? level can accurately eva-luate the peroxidation damage in neonates with jaundice.

High mobility group box chromosomal protein (HMGB1), an abundant eukaryotic nonhistone chromosomal protein, is previously known as a nuclear DNA-binding protein that stabilizes the structure and function of chromatin, regulates gene transcription. Recent studies identify that extracellular HMGB1 as a late mediator of endotoxemia and sepsis.HMGB1 is released by activated macrophages,induces the release of other proinflammatory mediators,and mediates lethality when overexpressed. It may also be a key signal for eliciting immune responses to cellular injury and death.Moreover,the late kinetics of HMGB1,in compared with other proinflammatory cytokines such as TNF and IL-1,suggest that targeting HMGB1 may provide a wide and clinically accessible therapeutic window.Three independent strategies to inhibit HMGB1 release and action are now available:anti-HMGB1 antibodies,A box,and ethyl pyruvate. This review covers the general features of HMGB1 and progress in research on its newly role as a cytokine participating in the development of sepsis.