Infection is an essential factor in chronic wound disunion. With the increasing number of patients with chronic diseases in the aging society, the number of patients with chronic wounds increases. It caused a heavy social burden. The proper cleaning method and cleaning fluid play a key role in chronic wound healing. In this paper, the concepts, classification, mechanism of different cleaning fluids, and their effects on chronic wounds were reviewed, which is expected to help health professionals to choose cleaning methods and cleaning fluids scientifically. It was supposed to provide significant guidance for chronic wound cleaning.

ObjectiveTo improve the teaching quality of medical humanity education in medical university.MethodsA cluster sampling survey was given to 448 sophomores who studied the outline of medical humanities course in military medical university,and the data were descriptively and statistically analyzed.ResultsThe survey shows that 90％ sophomores satisfy with this course,95％ sophomores understand the importance of medical humanity education,and the students have more requirements on education resources and teaching ways.ConclusionOutline of medical humanities course is important to cultivate the medical humanity spirit of medical students,and the course still needs more improvements.

Objective To investigate the expressions of TESTIN gene and Caspase-3 protein and thier relations with the clinicopathological features and prognosis of esophageal squamous cell carcinomas(ESCC). Methods The expressions of TESTIN and Caspase-3 in 50 ESCC tissues and paracancerous tissues (＞5 cm apart form the ESCC tissue) were detected by immunohistochemistry.The expression of TESTIN in 65 matched-pairs of ESCC tissues was detected by Western blotting and RT-PCR. The association of TESTIN and Caspase-3 with clinicopathological features and prognosis of ESCC were analyzed. Results The immunohistochemistry examination showed that the positive rates of TESTIN protein [30. 0% (15/50)] and Caspase-3 protein [24.0% ( 12/50)] were significantly lower in ESCC tissues than those in paracancerous tissues [(84. 0% (42/50) and 94. 0% (47/50),respectively, P＜0.01)]. The mRNA level of TESTIN was down-regulated in ESCC tissues (P＜0.05). Whereas the protein level of TESTIN was down-regulated in 45 (69.2%) of 65 ESCC tissues in comparison with paracancerous tissues. TESTIN expression was positively correlated with the differentiation of ESCC, but not associated with gender, age, tumor size, TNM stage and lymph node metastasis. There was a positive correlation between TESTIN and Caspase-3 in protein expressions (P＜0. 05). Patients with negative expression of TESTIN had lower survival rate compared to those with positive expression (P＜0. 05). Conclusions The positive relation between low-expression of TESTIN and Caspase-3 implicates that both are involved in the development of esophageal squamous cell carcinogenesis, and TESTIN might be a novel ESCC marker with prognostic significance.

Objective To evaluate the therapeutic effect of small bone flap craniotomy decompression of posterior cranial fossa and duraplasty in the treatment of Chiari malformation type Ⅰ.Methods The clinical data of 45 Chiari malformation type Ⅰ patients who were treated with small bone flap craniotomy decompression of posterior cranial fossa and duraplasty were retrospectively analyzed,31 cases among them with syringomyelia.Results According to Tator etc.standard,1 month after surgery,the excellent in 30 cases,good in 15 cases.Follow up from 6 months to 6 years,the excellent in 37 cases,good in 8 cases.Among 31 patients with syringomyelia,26 cases were syringomyelia subsided,5 cases were not obvious change.Conclusion The small bone flap craniotomy decompression of posterior cranial fossa and duraplasty can make the craniocervical decompression,and has obvious effect of treating syringomyelia,is safe and effective in treatment of Chiari malformation type Ⅰ.

ObjectiveTo explore the changes of serum high sensitive C-reaction protein (HS-CRP) and matrix metalloproteinase-9 (MMP-9) in patients with acute coronary syndrome (ACS) and their effects in nursing.Methods103 ACS patients, including 56 cases of unstable angina (UA)) and 47 cases of acute myocardial infarction (AMI), and other 40 persons (no abnormal results in coronary artery angiography, selected as control group) were examined for serum levels of HS-CRP and MMP-9. The difference among the groups was analyzed.ResultsThe HS-CRP levels of UA group, AMI group and control group were (3.87± 0.76 )g/L, (4.12 ±0.67)g/L and (1.67±0.38)g/L respectively; MMP-9 were (113.25±7.76)ng/ml, (193.09±25.87)ng/ml and (42.05±3.81)ng/ml respectively. The concentrations of HS-CRP and MMP-9 of ACS patients were significatly higher than those of the control group (P<0.01).ConclusionThe changes of HS-CRP and MMP-9 concentrations of ACS patients are remarkable, and may be as the markers to instruct nursing works.

Amygdala ; drug effects ; metabolism ; Animals ; Conditioning (Psychology) ; Morphine ; adverse effects ; Rats ; Receptors, Opioid, kappa ; metabolism

AIMTo detect the changes of inducible nitric oxide synthase (iNOS) expression in liver following ischemia/reperfusion (I/R) of hindlimbs and to elucidate their significance.

METHODSI/R was established using the occlusion of the femoral arteries for 4 h and reopening for 2-24 h in rats. The expression of iNOS mRNA, and iNOS protein and the nitrotyrosine (NT), a marker of peroxynitrite (ONOO-), in liver tissue were detected with reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical technique, respectively. The liver superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents were spectrophotometrically measured. The observation of pathologic changes of liver was made following the inhibition of iNOS by aminoguanidine (AG).

RESULTSCompared with control groups, the relative expression level of iNOS mRNA significantly increased in I/R group. There were more iNOS positive hepatocytes and more NT positive hepatocytes in I/R group than control groups. The contents of MDA markedly increased, while the activity of SOD significantly decreased in I/R group, compared with those in the control groups. The pathologic changes of rat liver became milder in I/R group following the inhibition of iNOS by AG.

CONCLUSIONThe expressions of iNOS mRNA and protein in liver are significantly upregulated, excess induction of iNOS-NO is contributed to the liver injury during the I/R of hindlimbs.

Animals ; Guanidines ; pharmacology ; Hindlimb ; blood supply ; Liver ; blood supply ; metabolism ; Male ; Malondialdehyde ; analysis ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; Superoxide Dismutase ; analysis

Objective To investigate the effect of intra-articular carboxymethylated ehitosan(CM- CTS)injection on inducible nitric oxide synthase(iNOS)expression in cartilage at the early stage of os- teoarthfitis(OA).Methods Thirty-two white rabbits were underwent unilateral anterior cruciate ligament transection(ACLT)and were randomly divided into 4 groups 5 weeks after transection.Rabbits of group A re- ceived 0.3 ml of 2% high molecular weight CMCTS(H-CMCTS)once every two weeks.Rabbits in group B were treated using 2% low molecular weight(L-CMCTS)CMCTS at:the same intervals.Group C rabbits were injected intra-articularly with 0.3 ml of 1% sodium hyaluronate(Na-HA)once a week.Animals of group D were not injected.At sacrifice,11 weeks following surgery,the expression of iNOS in cartilages was analyzed by immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCR)methods.Results Both immunohistochemistry and RT-PCR showed that the level of iNOS expression of cartilage in CMCTS in- jection groups was lower than that in Na-HA injection group and the untreated group.There was no significant difference in iNOS expression between the two different molecular weight CMCTS injection groups. No signifi- cant difference of iNOS expression in cartilage was found between Na-HA injection group and the untreated group.Conclusion CMCTS suppresses iNOS expression in cartilage during the early stage of OA.Na-HA treatment has no effect on iNOS expression in cartilage.

Objectives To evaluate the effect of thyroid hormone therapy with low dose of thyroxin on cardiac function in elderly patients with heart failure and sick euthyroid syndrome. Methods Forty-seven patients (33 males and 14 females, mean age 85.9+4.6 years,ranging from 80 to 99 years) with chronic heart failure (NYHA Ⅱ-Ⅳ) and low triiodothyronine (T3) state were randomly allocated to the treatment group or control group. The treatment group patients received oral administration of levothyroxine sodium (Euthyrox) 25-50mg/d in addition to conventional therapy of heart failure, whereas patients in control group were given conventional therapy only. Serum level of total T3 (TT3), free T3 (FT3), total thyroxine (TT4), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were determined. For both groups, left ventricular ejection fraction (LVEF) and stroke volume (SV) were assessed by two-dimensional echocardiography before and at 8 weeks after treatment. The changes of these parameters after the treatment were evaluated by adjusting heart rate in the two groups. Results The reduced serum T3 level in the treatment group was corrected after thyroid hormone therapy,and these patients had a significant improvement in cardiac function after treatment. By contrast, in the control group only changes of serum TT3 and TT4 levels and SV and LVEF after treatment were statistically significant. The heart rate-adjusted mean SV and LVEF in both groups were also increased, which was significantly greater in the treatment group than in the control group. Conclusion In the elderly patients with heart failure and sick euthyroid syndrome, addition of thyroxine at a low dosage to the conventional treatment could effectively improve the low T3 state and cardiac function independent of changes of heart rate.

Objective To study the effects of bundles of care on complications and unplanned extubation rate of neonatal in PICC .Methods 116 cases of neonatal which didn′t accept the bundles of care ware group A ,the other 93 cases of neonatal which accepted the bundles of care ware group B .Two groups were observed and compared on the incidence of complications and un-planned extubation rate and so on .Results The complications in A group treatment were 70 cases(60 .3% ) ,while there were 25 ca-ses in group B(26 .9% ) ,the group B was significantly lower than the group A (P<0 .05) .Mechanical phlebitis ,catheter occlusion , catheter ectopic and other aspects of ectopic group B were significantly lower than in group A (P<0 .05) .The rate of unplanned ex-tubation and catheter blockage in group B were significantly lower than A (P<0 .05) .The total rate of ectopic and right basilic vein ectopic rate in group B were all significantly lower in group A (P<0 .05) .Group B unplanned extubation rate and catheter blockage weresignificantlyloweringroupA(P<0.05).Gestationalagedidn′thaveimpactoncomplications(P>0.05),birthweightand catheter days had more impact on neonatal complications (P<0 .05) .Conclusion The cluster management can reduce the incidence of neonatal PICC complications ,reduce unplanned extubation rates ,better play the role of PICC ,try to arrange an experienced staff of medical operations for children of low birth weight newborns .