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.

HDL or apolipoprotein A-Ⅰ,the major protein of HDL particles,protect host against vascular endothelial dysfunction.HDL binding to scavenger receptor-BI activates eNOS for increasing NO.SR-BI and Endothelial lipase(EL) play a critical role in the regulation of plasma HDL.Incubation of HDL with vascular endothelial cells promotes prostacyclin synthesis.Some proteins such as paraoxonase that cotransport with HDL in plasma,have antioxidant properties.HDL inhibits TNF-? dependent expression of adhesion molecules in vascular endothelial cells and interferes with apoptosis,proliferation and migration of vascular endothelial cells.

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

Objective To examine the differences in the level of sedation and adverse effects produced by equivalent analgesic doses of remifentanil,sufentanil and fentanyl.Methods Eighty ASA Ⅰ female patients aged 18-39 yr with BMI of 18-25 kg/m2 scheduled for laparoscopic surgery under general anesthesia were randomly divided into 4 groups ( n =20 each):group control (group C) ; group remifentanil ( group R) ; group sufentanil (group S) and group fentanyl (group F).Remifentanil 2 μg/kg,sufentanil 0.2 μg/kg and fentanyl 2 μg/kg in normal saline 10 ml were infused iv over 2 min in groups R,S and F respectively.Depth of sedation was assessed and scored using OAA/S scale (5 =alert,1 =no response to prodding) and wavele index (WLI),before (baseline) and at 2,4,6,8 and 10 min after drug administration.Besides RR,pulse oxygen saturation,BP,HR were also monitored.The incidences of apnea,muscle rigidity,nausea and vomiting,pruritus,vertigo,bradycardia,profuse sweating and skin rash were measured and calculated.Results The 4 groups were comparable with respect to age,BMI and height.The lowest values of OAA/S scores,WLI and RR were significantly lower in groups R,S and F than in group C.Sufentanil produced the deepest sedation among the 3 opioids.Remifentanil produced strongest respiratory depression and nausea and vomiting.Conclusion The equivalent analgesic dose of sufentanil produces deeper sedation than that of remifentanil and fentanyl while remifentanil has the greatest impact on RR.

Objective To investigate the pulmonary morphologic changes and pulmonary surfactant protein A (SP-A) mRNA expression in fetal rats with maternal intrahepatic cholestasis of pregnancy (ICP).Methods Animal models of intrahepatic cholestasis of pregnancy were induced by 17-α-ethinylestradiol and progesterone.Histopathologic examination of the fetal lungs was performed under light and electronic microscopes.The expression of SP-A mRNA in the fetal lungs was measured by reverse transcription-polymerase chain reaction technique.Results (1) Compared with the control group,histopathologic examination showed that fetal pulmonary tissues had dilated and congested interstitial lung capillaries,thickened alveolar septum,mild focal inflammatory exudation and focal hemorrhage in alveolus.Furthermore,reduced microvilli,mitochondrion vacuolization,cytoplasm disintegration and increased lamellar body evacuation were observed in alveolar epithelial cell II in ICP group under light and electronic microscopes.(2) Expression of SP-A mRNA in fetal lungs of ICP group (0.71 + 0.10) was significantly lower than that in control group (1.00±0.27),t=3.093,P＜0.05.Conclusions Hyperbileacidemia in ICP maternal rat might lead to pathological changes in fetal pulmonary tissues.Low expression of SP-A mRNA might contribute to lesions of fetal lung with ICP.

Objective To investigate the influence of intrahepatic cholestasis of pregnancy (ICP) on the pulmonary morphologic changes of fetal rats.Methods Twenty pregnant SD rats at 15 days of gestations were randomly divided into ICP and control group.Rats in the ICP group were subcutaneously injected with 17-α-ethinylestradiol and progesterone for 5 consecutive days to establish the rat ICP model, and those of the control group received subcutaneous injection of sirasimeyu also for 5 days.The levels of serum alanine aminotransferases (ALT), aspartate transamlnase (AST), and total bile salt (TBA) were measured before and after the treatment, respectively.Maternal rats were sacrificed on 21 days of gestations and hysterotomies were performed immediately.Histopathologic changes of mammal rats' livers and fetal lungs were observed under light and electron microscopes.Results (1) The maternal serum levels of ALT, AST, and TBA showed no significant difference between the ICP and control group [ALT: (55 ± 15) vs (49 ±12) U/L; AST:(146±16)vs (145±20) U/L; TBA: (13±4) vs (14 ±4) μmol/L, P>0.05, respectively]before the ICP models were established, but higher levels were shown in the ICP group after [ALT: (94±12) vs (59±17) U/L; AST: (245±26) vs (163±27) U/L; TBA: (44±16) vs (17± 3) μmol/L, P <0.05, respectively].(2) The livers of maternal rats' in the ICP group were gloomy with blurred margins, however those of the control group were normal.Microscopic observed swollen and degenerated hepatocytes with narrowed hepatic sinusoid, dilated bile duct and necrosis of hepatocytes occasionally in the ICP group, while the morphology of hepatocytes and structures of lobuli hepatis in the control group were normal.(3) The fetal pulmonary tissues in the ICP group were dark, and normal in the control group.Histopathologic examination showed matured fetal pulmonary tissues with dilated and congested interstitial lung capillaries, thickened alveolar septum, mild focal inflammatory exudation and focal hemorrhage in alveolus.Furthermore, reduced microvilli, mitochondrion vacuolization, cytoplasm disintegration and increased lamellar body evacuation were observed in type Ⅱ pneumonocytes in ICP group under light and electron microscopes.While fetal pulmonary tissues of the control group did not show any significant lesions.Conclusions Rat model of ICP can be established with the combination of estrogen and progestin.Hyperbileacidemia in ICP rat may lead to pathological changes in fetal pulmonary tissues.

Objective To explore the feasibility of laparoscopical left hepatectomy with the method of Glis-son pedicle transsection.Methods Clinical data of anatomical left hepatectomy patients with the method of Glisson pedicle transsection from February 2012 to April 2012 in our hospital were retrospectively analyzed.Results All patients were completely suffered laparoscopical left hepatectomy with the method of Glisson pedicle transsection. Operation time form 2-4 hours,postoperative hospitalization for 6-7 days,all these patients were cured and discharged, without any complication of bile leakage, hemorrhage, peritonitis, intestinal obstruction, postoperative liver function recovered rapidly.There was no death case.Conclusion It is safe and feasible of laparoscopical left hepatectomy with the method of Glisson pedicle transsection and should be worth to popularize.

Objective To observe the relation between functions of vessels of lower extremities and TCM syndromes differentiation in diabetes patients. Methods Totally 168 diabetics of Type II were differentiated into 5 syndromes, i.e. 29 cases of yin deficiency with excessive heat, 41 cases of qi and yin deficiency, 30 cases of yin and yang deficiency, 37 cases of blood stasis in channels, and 31 cases of damp heat affecting the spleen, and 26 healthy people were involved in the control group. The peripheral vessel diagnostic system was adopted to get the toe photoplethysmogram (PPG) and ankle brachial index (ABI) to observe the blood perfusion of limb terminals and the functional state of lower limb arteries. The relation between function of vessels of lower extremities and TCM syndrome was analyzed. Results All the diabetic groups were related with the arterial blood supply of toe terminals. Diabetes was the main risk factor in affecting the terminal blood supply (P

Studying of atherosclerosis is more than a hundred year.There are many theories about this disease,but now most of us seems to agree with the stress-reponse theory.Heat shock proteins are the products produced at the first stage of atherosclerosis.And someone think that it may have something to do with atherosclerosis.This paper discussed the heat shock proteins and atherosclerosis respectively,and emphasized the relationship between them.

Objective:To investigate the cardiac magnetic resonance technique in the diagnosis and treatment of unstable angina application value. Methods:The hospital diagnosed patients with unstable angina as research subjects, were given coronary angiography in patients (CAG) examination, ECG, echocardiography and cardiac MRI examination, recording the results and statistical analysis. Results:Cardiac MRI for>90%stenos is detected heart rate, and coronary angiography (CAG) showed no significant difference (x2=3.257, P>0.05), for<90%stenos is detection rate, and coronary angiography (CAG) was statistically significant between test results (x2=17.267, x2=25.714;P<0.05);cardiac magnetic resonance for the degree of stenos is of myocardial ischemia in patients with high detection rate and electrocardiogram detection rates were significantly different(x2=4.65, P<0.05), but the total no significant difference between the detection rate(x2=0.251, P>0.05);cardiac MRI for cardiac function and cardiac structure determination is better than conventional echocardiography. Conclusion: Cardiac MRI technology to more accurately reflect changes in cardiac structure and function of the stenos is and effort ischemia detection rate with conventional inspection methods have better consistency.