Objective To systematically evaluate the effectiveness of using gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU.Methods The randomized controlled trials (RCTs) on the application of gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU were collected through the databases such as the China National Knowledge Infrastructure (CNKI),China Scientific Journal Database by VIP (VIP) and Wanfang Database.The quality of studies was critically appraised and data were extracted by two reviewers independently.Meta-analysis was conducted for the included studies.Results Eleven RCTs involving 1 337 patients were included.Meta-analysis showed that the application of gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU could reduce ventilator-associated pneumonia (VAP) incidence rate[RR=0.54,95％CI(0.44-0.65),P ＜ 0.01],shorten the duration of mechanical ventilation [mean differences(MD)=-2.38,95％CI(-2.69--2.07),P ＜ 0.01] and length of ICU [MD=-3.66,95％CI (-5.45--1.87),P ＜ 0.01],but the mortality rate was not statistically significant [RR=0.37,95％CI (0.11-1.26),P ＞ 0.05].Conclusions The application of gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU is safe and effective.

Objective:To Study the molecular mechanism of Guizhi Fuling Bolus(GFW) controlling the tumor growth.Methods:Each of 30 mice received 0.2ml S180 tumor cell suspension subcutaneously in the right axilla.The mice were randomly divided into model group,GFW group and Cyclophosphane(CY) group and with 10 mice in each group.Another ten mice without cancer were used as control.The model group received intragastric normal saline,0.2ml?10g-1?d-1;the GFW group was given intragastric administration,0.2ml?10g-1?d-1 whilst the CY group received intraperitoneal injection of CY at 20mg?kg-1?d-1.The medicines were given to the mice in each group after they were inoculated,once a day for 10 days.The mice were sacrificed and the tumor removed,the S180 mice sarcoma model was used to detect the inhibiting effects of GFW.The protein expressions of P21waf/cip and mRNA expression of Survivin were evaluated by immunohistochemistry and in situ hybridization.Results:For S180 sarcoma,the inhibiting ratio of GFW was 38.93%.Survivin mRNA was markedly declined in the GFW group when compared with the model group(P

Actins ; metabolism ; Animals ; Antigens, CD ; metabolism ; Cadherins ; metabolism ; Carotid Artery Injuries ; metabolism ; pathology ; Endothelium, Vascular ; metabolism ; ultrastructure ; Fluorescent Antibody Technique ; Microscopy, Confocal ; Rats ; Troponin ; metabolism

Objective To describe the health literacy level and to explore the effect of health literacy level on education retention of patients with stroke.Methods Totally 100 stroke survivors were selected as the subject by convenience sampling.They were evaluated by Short Test of Functional Health Literacy in Adults on admission,and they accepted 60-90 minutes education intervention during hospitalization.Evaluation retention were measured before discharge.Results The score of the overall health literacy was (15.60±1.36) points,among of them,low level was 37 cases,general level was 24 cases,high level was 39 cases.Age,education level and Mini-Mental Status Exam score had a significant effect on the health literacy of patients with stroke (x2/F=14.248,12.082,11.329,P＜ 0.05).After education intervention,the score of education retention was (6.69±2.00)points,and the score of education retention in low,general,high level health literacy were (5.08±2.06),(7.46±1.61),(7.51± 1.76) points,and there were significant differences(F=14.223,P ＜ 0.05).Heahh literacy had a effect on education(P ＜ 0.01).Conclusions The level of health literacy of stroke patients has the effect of improving the education retention.Improving and maintaining the health literacy of stroke patients should be the development direction of the prevention and treatment of stroke diseases.

Objective To analyze the expression of long non-coding RNA ( lncRNA) in renal clear cell carcinoma ( RCCC ) , the association of lncRNA with RCCC, as well as the role of lncRNA in the diagnosis and treatment of RCCC.Methods Forty fresh RCCC tissues and their normal adjacent tissues were collected from March 2012 to June 2013, and total RNA was extracted using Trizol reagents, purified and tested by denaturing agarose gel electrophmesis and NanoDrop 1000.Through Arraystar Human LncRNA Microarray, the different expression of lncRNA between RCCC and normal adjacent tissues was screened. RT-qPCR was used to verify the expression of lncRNA in 40 pair RCCC tissues and normal adjacent tissues. The receiver-operating characteristic ( ROC ) curve was adopted to verify the diagnostic efficiency of the selected lncRNA.Results LncRNA expression profile showed 1 787 lncRNA with expression alteration in two fold or above, up-regulated and down-regulated candidate lncRNAs were 941 and 846 respectively. Compared with the adjacent tissues, NR_034095 and NR_038974 were up-regulated in RCCC, and ENST00000571724 and ENST00000566575 were down-regulated, which were consistent with the microarray analysis.By the ROC curves of NR_034095, NR_038974, ENST00000571724 and ENST00000566575 to discriminate the RCCC from normal adjacent tissue, the area under curve was 0.928 ( 95%CI 0.873 -0.984), 0.759 (95%CI 0.647-0.871), 0.833 (95%CI 0.747-0.919) and 0.887 (95%CI 0.815-0.959 ) , respectively.Conclusions NR _ 034095, NR _ 038974, ENST00000571724 and ENST00000566575 are significantly differently expressed in RCCC.The different expressed lncRNA might be closely related to the process of RCCC, and may be used as a new candidate target for molecular diagnosis and gene therapy of RCCC.

Objective To investigate one year survival rate and life quality of patients with non-small cell lung cancer(NSCLC)treated by different arms.Methods One hundred and seventy-nine cases NSCLC patients from January 2013 to December 2014 were selected from the Third Hospital of Tanshan and followed-up,including 57 cases with surgical treatment,70 cases with the use of Navelbine plus cisplatin,52 cases with dendritic cells(DC)and cytokine induced killer cells(CIK)immune based therapy(DC/CIK)treatment.After one year period of radiotherapy and chemotherapy,the SF-36 questionnaire was used to investigate the quality of life of the surviving patients,and the quality of life was assessed from three aspects of the physiological,psychological and social functions.To quantify the quality of life score,the 100 percentage grading system was adopted,logistic regression analysis was used to adjust the influence of age and gender on survival rate,and the data were analyzed by SAS 9.2 statistical software package.Results One hundred and seventy-nine subjects were included in this study,by the end of follow-up on December 2015,there were 119 cases survived,the survival rate was 66.5％(119/179).Survival rate of surgical operation group,DC/CIK group and chemotherapy group orderly decreased(82.5％(47/57),76.9％(40/52)and 45.7％(32/70),P＜0.01).After adjusting age and gender impact,multiple logistic regression model showed that DC/CIK group survival rate was 3.96 times higher than the pure chemotherapy group(95％CI=1.78-8.80),surgical operation group was 5.58 times higher than simple chemotherapy group(95％CI=2.44-12.79).There were no significant differences between DC/CIK group and surgical operation group on physical disease,health status,emotional intelligence,mental health and social function,no significant difference(P＞0.05),but the chemotherapy group was lower(P＜0.05);physiological function in the chemotherapy group,operation group and DC/CIK group showed an increasing trend(P＜0.05).Conclusion The one year survival rate of NSCLC patients treated by different arms is 66.5％,and the life quality of patients with biological immune therapy method is better.

Objective To analyze the changes of leptin and adiponectin levels in serum of patients with diabetic retinopathy and investigate their chnical significance in diabetic retinopathy (DR).Methods One hundred and twenty-one patients with type 2 diabetes mellitus as the case group who hospitalized from Nov.2012 to Nov.2013.Among the patients,41 cases of non-DR,40 cases of nonproliferative-DR,40 cases of proliferativeDR.Forty healthy were served as the control group.The levels of leptin and adiponectin in serum were detected by Enzyme-Linked Immuno Sorbent Assay (ELISA).Results The overall levels of leptin in case group was (15.25 ± 4.70) μg/L,significantly higher than the control group ((6.15 ± 1.70) μg/L; t =-11.696,P ＜0.01)).The level of adiponectin in case group was (7.39 ± 1.92) mg/L,lower than the control group ((11.10 ± 1.46) mg/L; t =11.216,P ＜ 0.01).Moreover,the levels of leptin increased successively from (10.91 ±1.21) μg/L in NDR,(15.22 ±3.75) μg/ L in NPDR and (20.50 ±3.70) μg/L in PDR.While,the adiponectin levels decreased from (9.61 ± 1.35) mg/L in NDR,(7.11 ± 1.18) mg/L in NPDR and (5.34 ± 1.36) mg/L in PDR respectively.And the differences between the groups were significant(F =149,542,291,550;P ＜0.05).The levels of leptin and adiponectin in serum showed a negative correlation (r =-0.662,P ＜0.01).Condusion Levels of leptin and adiponectin in serum associate with DR,and both of them might be the important indexes for the prediction and curative effect evaluation of DR.

Objective To discusses the value of combined CA125 and CT/MR/ in diagnosing the ovarian thecoma.Methods Forty cases of patients with ovarian thecoma were retrospectively analyzed.The results of CA125 and the appearance of CT and MRI were recorded,the value of CA125 changes and CT/MRI features was analysed in the diagnosis of ovarian thecoma.Results The value of CA125 elevated in 17 cases of ovarian thecoma,and showed statistical significance in the ratio((12/35 vs.5/5;x2=2.274,P=0.046) and the levels of the value of CA125 ((90.24 ± 18.56) U/ml vs.(243.35 ± 20.45) U/ml;t =7.780,P =0.002).Compared with 40 cases of control group,elevated CA125 level showed no obviously statistical significance (t =5.348,P=0.22).Forty patients in CT and MRI were all single lesion,30 cases were solid neoplasm,the rest were cystic-solidary lesions or priority of cystic component,75％ lesions were more than 5 cm,9 cases of lesions contains calcification.In pre-enhanced CT and MR/scan the lesions showed iso-density or signal-intensity,mildly enhanced;Twenty-two patients with ascites and 11 cases with symptoms in the elevating of estrogen.Combined the results of CA125 and the apperaance of CT and MR/,the accuracy of the diagnosis in ovarian thecoma was 85％.Conclusion CT and MR/imaging combining with CA125 can improve the diagnosis accuracy of ovarian thecoma.which should be given priorities.

BACKGROUND:The technique of vacuum sealing drainage, initialy used for better wound healing, has been widely applied to al kinds of refractory wounds. OBJECTIVE:To summarize the research progress in vacuum sealing drainage for treatment of severe soft tissue injury. METHODS: An electronic retrieve was performed in Wanfang database, VIP database and PubMed database from January 1989 to August 2014 was performed for papers regarding the vacuum sealing drainage technology with the key words of “vacuum sealing drainage technology; injury; gentamicin; hyperbaric oxygen; nerve growth factor; chymotrypsin” in Chinese or English. Finaly 48 articles were involved in the final analysis according to the inclusion criteria. RESULTS AND CONCLUSION:Vacuum sealing drainage is a highly effective treatment technique to promote wound healing which can promote wound blood circulation, reduce sweling, inhibit bacterial growth, stimulate growth of granulation tissue by mechanical stress, inhibit cel apoptosis, thereby helping wound healing. Compared to conventional open-dressings, vacuum sealing drainage has a faster wound healing speed, lower infection rate, and fewer dressing change frequency. With recent advances in medicine, vacuum sealing drainagetechnology cannot be simply used for treatment of skin soft tissue damage, but in combination with gentamicin, hyperbaric oxygen, nerve growth factor and chymotrypsin to achieve better therapeutic effects.

Objective To investigate the clinical applications of coronary CT angiography in patients with suspected coronary artery disease and identify factors that affect CT findings. Methods Medical records of patients suspected of coronary artery disease over a period of 12 months from a tertiary teaching hospital were retrospectively reviewed. Patient age, sex (male/female), duration of symptoms and abnormal rates of coronary CT angiography scans were analysed to investigate the relationship among these parameters. The patients by age were duration of symptoms was also classified into five groups: less than one week, one week to one month, one to three months, three to six months and more than six months. Results Of the 880 patient records reviewed, 800 met the above study criteria. Five hundred and forty nine patients demonstrated abnormal CT findings (68.6%). There was no significant difference in the percentage of abnormal CT findings based on patient sex and the duration of symptoms (P = 0.14). The abnormal rates of coronary CT angiography, however, increased significantly with increasing age (P < 0.001); with patients over 65 years of age 2.5 times more likely to have an abnormal CT scan relative to a patient under 45 years. A significant difference was found between abnormal coronary CT angiography and the duration of symptoms (P = 0.012). Conclusions Our results indicate coronary CT angiography findings are significantly related to the patient age group and duration of symptoms. Clinical referral for coronary CT angiography of patients with suspected coronary artery disease needs to be justified with regard to the judicious use of this imaging modality.