Objective To make a systematic review of pressure ulcers risk factors in critically ill patients. Methods We systematically reviewed all articles related to the pressure ulcers risk factors in critically ill patients. The Cochrane Library, PubMed, EMBASE, Web of Science Core Collection, CNKI, WANFANG and SinoMed were searched to August 2016. Results In total, 13 eligible articles were included. These studies included 18, 184 critically ill patients, six studies were classified as high quality, and seven were classified as moderate quality. Risk factors for the development of pressure ulcers include age, ICU stay, diabetes, mean arterial pressure<60-70 mmHg (1 mmHg=0.133 kPa), mechanical ventilation and mechanical ventilation, drugs, sedation and postural changes. Conclusions There is no single factor that can explain the occurrence of pressure ulcers. So it is in a variety of factors interaction, the occurrence of a significant increase in risk.

Objective To analyze the clinical effect of debridement in the treatment of Kashin-Beck disease under an ankle arthroscopy.Methods Totally 40 patients with ankle Kashin-Beck disease who had underwent surgery in the Fifth Hospital of Daqing from January 2015 to October 2016 were selected as the research subjects.All patients were treated with cleaning treatment under arthroscopy,evaluated via the visual analogue scale method,and compared pain before and 6,12 month after the treatment.Walking function and ankle motion of the patients were evaluated via an ankle-scoring system,and the quality of life of patients was investigated before and after the treatment through a questionnaire survey.Results The visual analogue scale of before and 6,12 months after the treatment was (6.2 ± 1.0),(2.3 ± 1.2) and (1.6 ± 0.4) scores,respectively;ankle foot score (53.3 ± 6.8),(86.6 ± 5.1) and (88.7 ± 6.2) scores,respectively;ankle activity score (15.9 ± 4.1),(36.9 ± 4.9) and (41.8 ± 6.4) scores,respectively;and life quality score (53.1 ± 4.0),(75.4 ± 6.6) and (88.7 ± 10.5) scores,respectively.The differences between groups were statistically significant (F =2.1,2.6,2.3,2.5,P ＜ 0.05).Visual analogue scale of 6 and 12 months after the treatment was significantly lower than that before the treatment,ankle foot score and ankle activity score and life quality score were significantly higher than those before the treatment (P ＜ 0.05).Conclusion The debridement under an ankle arthroscopy can effectively reduce the pain of patients with Kashin-Beck disease,and improve the walking function of the patients obviously,significantly improve the patients' life quality,and the method should be widely applied in clinical treatment.

Objective To discuss the value of amplitude integrated electroencephalographic(aEEG) monitoring in early neonatal brain injury and prognosis of asphyxia neonatal.Methods Seventy-two subjects of asphyxia children were divided into mild asphyxia group and severe asphyxia group.We selected 45 cases of full-term healthy children born in our hospital as control group in the same term.All the objects were observed by aEEG monitoring within 6 hours.According to the aEEG results,all the samples were redivided into normal aEEG group,mildly abnormal aEEG group and severely abnormal aEEG group.All subjects were followed-up to observe their physical growth and the nervous system development at one-year-old.Results Incidence of abnormal aEEG in mild asphyxia group and severe asphyxia group was significantly higher than that of control group(x2 =26.996,47.07,P ＜ 0.01,respectively),and incidence of abnormal aEEG in severe asphyxia group was significantly higher than that of mild asphyxia group (x2 =7.76,P ＜ 0.05).There was no significant difference in all subjects about physical development (height and weight) (P ＞ 0.05),all of their mental index and developmental quotient were lower in severely abnormal aEEG group (x2 =13.450,15.285,P ＜ 0.01,respectively).Conclusion aEEG can be used to assess the early neonatal brain injury of asphyxia neonatal,and it can be used to predict the prognosis of neonatal asphyxia based on the abnormal degree of aEEG.

Aim To investigate the protective effects of polysaccharides from the rhizomorph of Armillaria mella(AMP-1) on alloxan injured INS-1 cells.Methods Graded concentrations of AMP-1(2,10,50,100,500,1 000 mg?L-1) were added into the culture medium of alloxan injured INS-1 cells.The survival rate was measured by MTT assay.The amount of glucose-stimulated insulin secretion in different concentrations of AMP-1 was determined by radioimmunoassay(RIA).SOD and NOS activity,NO,MDA and GSH production were assayed colorimetrically.Results AMP-1 could reduce oxidative injuries induced by alloxan in INS-1 cells.The survival rate of cells treated with AMP-1 increased significantly.In the presence of 5.6 mmol?L-1 or 16.7 mmol?L-1 glucose,AMP-1(50,100,500,1 000 mg?L-1)increased glucose-induced insulin secretion in INS-1 cells in a dose-dependent manner.NOS levels and the production of NO and MDA decreased significantly by AMP-1,while SOD levels and the production of GSH increased.Conclusions AMP-1 promoted glucose-induced insulin secretion in INS-1 cells by increasing the abilities of scavenging the free radicals induced by alloxan.

Objective To explore the role of transcription factors such as nuclear factor-kappa B(NF-?B) and glucocorticoid receptor(GR) in the pathogenesis of Adriamycin(ADM)-induced nephrosis in rats and the therapeutic effects of dexamethasone(Dex) and cyclosporin(CsA) on these animals.Methods The DNA-binding abilities of NF-?B and GR in cortex of kindey were examined with electrophoretic mobility shift assay(EMSA) and isotopic radioautography on the 7th,14th,21th and 28th day after a single intravenous injection of ADM,and the therapeutic effects of Dex and CsA were estimated.The biochemistry parameters from blood and urine of rats and the urine protein excretion were also measured.Results The NF-?B DNA-binding ability was significantly increased after 7 days and achieved maximum after 28 days(P0.05).Conclusion The DNA-binding ability of NF-?B is abnormally increased and that of GR is decreased in cells from cortex of kindey in Adriamycin-induced nephrotic rats.The NF-?B DNA-binding ability can be inhibited and the urine protein excretion is decreased by the treatment of CsA.

Objective:To differentiate human embryonic stem cells ( hESCs ) into keratinocytes ( K-hESCs) and analyse the expression characteristics of biomarkers of K-hESCs.Methods: The hESCs of line H9 were seeded on matrigel in mTeSR1 medium.The hESCs were directly differentiated into kerati-nocytes in epithelial differentiation medium with bone morphogenetic protein 4, retinoic acid and N2 sup-plement.The karyotype of K-hESCs was analyzed, comparing the gene expression differences of K-hESCs with human gingival epithelial cells (HGECs), human immortalized oral epithelial cells (HIOECs) and HaCaT by Real-time PCR.Molecular characteristics of the cell differentiation were observed throughout the process by immunocytochemical techniques.Results:H9-hESCs were successfully differentiated into the cells that exhibited characteristics of keratinocytes in epithelial differentiation medium.The karyotype of K-hESCs was 46, XX; and the keratinocyte gene p63 expression in K-hESCs was significantly lower than that in HaCaT ( P<0.05) , but there was no significant difference of p63 expression in K-hESCs, comparing with that in HGECs and HIOECs ( P >0.05 ) .Conclusion: H9-hESCs could be directly differentiated into K-hESCs.The gene expression of K-hESCs was similar to that of epithelial cells in the early stage of monolayer cells differentiation with high proliferative activity.

0.05).ConclusionThe neoadjuvant radiochemotherapy can improve the sphincter-saving rate,probably can improve the resection rate and reduce the recurrence rate for the middle-lower rectal carcinoma.

BACKGROUND:After spinal cord injury, endogenous neural stem cel s are activated to proliferate and migrate to repair damaged tissue. As a clinical medicine, methylprednisolone shows a lot of functions, but its effects on endogenous neural stem cel s are stil unknown.
OBJECTIVE:To explore the effects of methylprednisolone on the proliferation and migration of endogenous neural stem cel s after spinal cord injury.
METHODS:Seventy-five Sprague-Dawley rats were used to make animal models of T10 complete paraplegia using Al en’s method, and randomized into methylprednisolone, normal saline and model groups. Rats in these three groups were given intraperitoneal injection of 1 g/L methylprednisolone solution at a dose of 30 mg/kg for 10 minutes and at a dose of 5.4 mg/kg/h for 23 hours, given intraperitoneal injection of normal saline at the same dose and given no treatment, respectively. Neurological and motor functions were assessed by somatosensory evoked potential and Basso Beattie Bresnahan scores at 7, 14, 21, 28 days after spinal cord injury. BrdU and Nestin staining of the injured spinal cord segment was conducted.
RESULTS AND CONCLUSION:A large amount of BrdU-and Nestin-positive cel s were visible in al the groups, and the number of these cel s reached the peach at 14 days after spinal cord injury. Methylprednisolone was found to inhibit BrdU-, Nestin-or double-positive cel s, indicating methylprednisolone can inhibit the proliferation and migration of endogenous neural stem cel s. The results of Basso Beattie Bresnahan scores showed no notable improvement in the motor function of the limbs. Methylprednisolone also showed no significant effects on the motor evoked potential latency, but promoted nerve conduction recovery. Al these findings indicate that methylprednisolone has some hindering effects on spinal cord repair by inhibiting the proliferation and migration of endogenous neural stem cel s after spinal cord injury.

We detected the isoniazid resistance in clinical Mycobacterium tuberculosis isolates by high-resolution melting (HRM) curve analysis and assessed the application value of the assay.The isoniazid resistance of 49 M.tuberculosis isolates preserved in laboratory was analyzed by the drug sensitivity test (traditional proportion method).Further analysis was made on the sequencing of the isoniazid resistance determining region in these test strains,and their mutation sites were screened.Specific primers used in the HRM curve analysis were designed based on the screened mutation sites,DNA mutations were assayed in the isoniazid-resistant gene determining region by the HRM curve analysis,and an assessment was made of the detection efficiency of the assay in isoniazid resistance in M.tuberculosis.Results of the drug sensitivity test (proportion method) showed that,of the 49 test strains,there were 20 isoniazid-resistant strains,29 isoniazid-sensitive strains.Results of the sequencing analysis showed that:1) KatG gene had four mutation patterns,i.e.,point mutations at site 234,at sites 234 and 315,at sites 234 and 463,and at sites 234,315 and 463;2) there were three mutations were detected in inhA gene,i.e.,mutations in inhA-8,-15 and-152.Analysis of gene mutation in drug-resistant strains found that of the 20 isoniazid-resistant strains,11 (55 ％) were mutated at codon 315 of KatG gene;6 (30％) were mutated in inhA-15 (4/20),-8 (1/20) and-153 (1/20) of inhA gene;two (10％) were mutated at codon 315 of KatG gene and in inhA-15;in one strain (5％),no mutation was detected in KatG and inhA genes.Through the gene mutation detection,the sensitivity and specificity of isoniazid resistance in M.tuberculosis were 95 ％ and 100 ％,respectively.Results of HRM curve analysis of drug-resistance gene mutations in test strains showed gene mutations were present in 18 strains and absent in 24 ones;referring to DNA sequencing results,the sensitivity and specificity of the assay were 94.7％ and 80％,respectively.Judged by mutations as drug-resistance via the HRM curve analysis,19 resistant and 24 sensitive strains were tested.With the drug sensitivity test results by the proportion method as controls,the sensitivity and specificity of the assay were 95 ％ and 82.76 ％,respectively.Use of the HRM curve in the detection of resistance of M.tuberculosis to isoniazid is characterized by good sensitivity and short time consuming,and has certain value in the rapid diagnosis of isoniazid-resistant tuberculosis.

Objective To evaluate the risk factors of septic shock after mini-percutaneous nephrolithotripsy (mPCNL). Methods Clinical data of 1 590 cases who underwent mPCNL from January 2013 to December 2014 were retrospectively analyzed. The x2 test and logistic regression were used to identify the key risk factors for septic shock after mPCNL. Results Of the 1 590 patients, 18 patients suffered septic shock, including 6 male patients and 12 fe﹣male patients. Their mean age was (45.6 ± 13.5) years (28 ~ 69 years). White cell in urine was 100 percent, the stone diameter ranged from 1.5 to 5.0 cm, unichannel for 15 cases while multichannel for 3 cases, the operation du﹣ration ranged from 45 to 200 min, mean (87.0 ± 56.0) min. 2 in 18 cases died in multiple organ failure, the others recovered till discharged. In x2 test, female gender (P = 0.001), (+++ ~ ++++) white cells in urine (P= 0.042), un-preoperative nephrostomy drainage (P=0.041) had significant association with septic shock after mPCNL. While in multivariate analysis, female gender ( O? = 5.471, 95 % CI: 0.756~21.452, P< 0.05) and un-preoperative nephrostomy drainage (O? =3.106, 95%CI:1.283~7.907, P<0.05) were identified as independent risk factors for septic shock after mPCNL. Conclusions Female gender and un-preoperative nephrostomy drainage are the key risk factors for septic shock after mPCNL.