Objective To know the progress of research in oral care of orotracheal intubated patients in China and to analyze the existing problems as well as provide the reference for further study.Methods Databases of CNKI,Wanfang,VIP and CBM were searched for literature on oral care for the orotracheal intubated patients by the end of December 2013,and the methods of bibliometrics were used to analyze the research results.Results Three hundred and nine articles that met the inclusion and exclusion criteria from 1997 to 2013 were collected.These papers were mainly included in 22 kinds of nursing journals.The methods of oral care for orotracheal intubated patients could be classified into five types:rinse and swabbing (95 papers),traditional cotton(cotton swab) cleaning or gauze swabbing (58 papers),toothbrushing (54 papers),oral rinse (51 papers),laryngoscope assistance (7 papers).With 54 articles using traditional cotton balls as oral care tool,55 papers using toothbrush,including children toothbrush of soft bristle (29 papers),ordinary toothbrush (14 papers) and electric toothbrush (12 papers).Oral care solution mainly included normal saline(49 papers),traditional Chinese medicine (36 papers),chlorhexidine(36 papers),antibiotics (12 papers),povidone iodine (17 papers),sodium bicarbonate (9 papers),etc.Conclusions The oral care of orotracheal intubated patients has attracted the attention of researchers,but the use of oral care methods,the frequency in oral care and oral care tools still owe specification.More attention should be paid to strengthen the training of nursing staff,to improve the scientific research ability of scientific research workers and to carry out large sample and high quality trials.An oral care guideline that fits into our national conditions should be built in an effort to improve the level of oral care in critical patients in our country.

Objective To investigate the change of the content of suppressor of cytokine signaling (SOCS-1) in the liver of septic mice and its working mechanism.Methods Adopted Cecalligation and puncture (CLP) to create models of sepsis and divided randomly adult male BALB/c mice into 8 groups,including normal controlled group,sham-operated group,and the killed groups 2 hours,6 hours,12 hours,24 hours and 48 hours after operation.After extracting the RNA and protein from the liver tissue of the mouse groups,reverse transcription polymerase chain reaction (RT-PCR) was adopted to determine the relative content of SOCS-1 mRNA in the tissue,Western blot was adopted to determine the relative content of protein and the SPSS statistics software was adopted to calculate the correlation.Then observed the pathological change of liver tissues,and detected SOCS-1 protein expression by immunohistochemistry.Results After CLP suergery,the expression of SOCS-1 on gene degree in the liver and the expression of SOCS1 on protein degree in the liver increased rapidly at the 6th hour ( P ＜ 0.05 ),with the former reaching peak ( P ＜ 0.05 ) at the 24th hour and the latter remaining high all the time.There were pathological changes such as fatty degeneration and necrosis in the septic liver tissue,hepatic SOCS-1 protein expression could be detected by immunohistochemistry.Conclusions CLP induced sepsis could lead to the increase of the expression of SOCS1 in the liver.

Objective To investigate the treatment of urinary tract obstruction after kidney transplantation, and to introduce the novel ‘antegrade percutaneous urinary tract throughout guidance technique’ with guide wire in selected patients. Methods 43 cases of renal transplantation patients due to urinary tract obstruction (ureteral stenosis and hydronephrosis in 24 cases, urinary calculi with or not ureteral stenosis in 19 cases) received endourological treatment. Retrograde pathway was tried firstly, if failed, antegrade pathway was adopted with‘antegrade percutaneous urinary tract throughout guidance technique’, 18 Fr percutaneous tract was established if necessary, endoscopy was needed in antegrade or combine with retrograde pathway. Results Of the 43 patients, 9 (20.9 %) patients were managed directly through the retrograde ureteroscopy, 28 (65.1 %) patients were managed with anterograde percutaneous technique in 18 Fr tract, 6 (14.0 %) patients were treated with ‘antegrade percutaneous urinary tract throughout guidance technique’. Operation time was (72.0 ± 16.0) (45 ~ 95) minutes. Postoperative stone clearance rate of 89.5 % (17/19). Of 32 cases with ureteral stricture, 6 (6/32, 18.8 %) cases were cured after one time of dilation and JJ stent indwelling for 2 months, 18 (56.3%) cases with stable hydronephrosis after 2-3 times of dilation and JJ stent indwelling, 5 cases (15.6 %) needed long-term repeated stent indwelling for drainage, 3 (9.4%) cases required nephrostomy tube drainage. Conclusion Minimally invasive treatment of urinary tract obstruction after renal transplantation is effective. Antegrade percutaneous urinary tract throughout guidance technique provided a powerful guarantee for retrograde operation and avoided the bleeding risk following percutaneous renal surgery, when combined with flexible ureteroscopy, urinary calculi in patients with kidney transplantation can be effectively managed with little trauma.

Objective To evaluate the efficacy and advantages of the technique by combined PCNL and retrograde intrarenal surgery (RIRS) in a second stage to treat the complex renal stones in solitary kidney cases.Methods PCNL most with a single 18-24 F tract was performed first and RIRS was carried out at a second stage in solitary kidneys of 21 patients,of which congenital in 14.3％ (3 cases),contralateral nephrectomy in 42.8％ (9 cases),and functional solitry kidneys in 42.8％ (9 cases).Of the 21 patients,the average age was 45 years with 15 males and 6 females.The stones were 8 multiple,6 partial staghorn,and 7 complete staghorn with a mean size of 4.6 (3.8-6.8) cm.Results Of the 21 PCNL cases,a single tract,double,triple tracts were established in 18 (85.7％),2 (9.5％),1 (4.8％) cases,respectively.Mean operation time of PCNL was 95 (45-175) min.After 1 day of PCNL,all case had residual stones with a mean size of 1.9 (1.0-3.5) cm.Two case occurred fever after PCNL and one case presented bleeding resolved by selective renal artery embolization.The mean operation time of RIRS was 72 (35-95) min.Stone-free rate after RIRS was 85.7％ (18/21).The final stone free rate increased to 95.2％ (20/21) after one case received a second-look PCNL and two cases accepted ESWL.Two cases occurred fever and steinstrasses after RIRS resolved by rigid ureteroscopy.At the 3 months follow-up,renal function became stable,improved and worse in 71.4％ (n=15),23.8％ (n=5),and 4.8％ (n=l) of patients.Conclusions PCNL combined with RIRS could be an effective and safe option for complex stones in solitary kidneys with less bleeding,reduced tracts,minor complications and good renal function preservation.

Objective To compare the efficiency between mini-percutaneous nephrolithotomy (MPCNL) and extracorporeal shock wave lithotripsy (ESWL) for monotherapy of renal calculi in infants less than 3 years.Methods Forty-six infants were treated with either SWL (22 infants) or MPCNL monotherapy (24 infants).The mean age was (22.6 ± 8.7) months vs (23.5 ± 6.6) months and the stone size was (21.4 ± 3.5) mm vs (21.7 ± 1.7) mm,and there were no significant difference.Results For MPCNL,mean operating time was (76.2 ± 23.4) min and mean hospital stay was (14.13 ± 5.8) d.The stone-free rates were 84.0％ (21/25) after first session and 96.0％ (24/25) after second-look procedure.Postoperative fever happened in 4 (16.0％) cases.Hemoglobin drop was (8.5 ± 4.4) g/L and no one needed blood transfusion.For ESWL,the stone-free rate were 31.8％ (7/22) after first session and 86.3％ (19/22) after second session for 11 infants (50.0％).Mean hospital stay was (6.6 ± 2.3) d and 10 cases (45.5％)had complications.Hemoglobin drop was (10.6 ± 12.7) g/L.MPCNL was lower than ESWL in complications rate and re-treatment rate,and the stone-free rate was higher,but the hospital stay and operation time was longer (P ＜ 0.05).GFR revealed improve or stable after operation in both groups.Conclusions For a higher success rate,lower complication rate and re-treatment rate,MPCNL was an effective option for the management of relatively larger stones in children (even in infants).

Objective To investigate and compare the clinical effects of intraarticular injection of sodium hyaluronate and diprospan on knee osteoarthritis. Methods 94 patients with knee osteoarthritis were divided into two groups, the HA group and Cortieosteroid group. Each patient in the HA group was treated with intra-articular injection of sodium hyaluronate at 2.5 ml every week for 5 weeks, and each patient in the Corticosteroid group was treated with intra-articular injection of diprospan at 1ml on the first and fourth week. The clinical assessments included pain,joint effusion,and Lequesne Index. Assessments were done at baseline, at week 4, and week 12. Results 88 cases were followed up for 3 months. A significant decrease in VAS scores for pain and in Lequesne Index was found in both groups at week 4 when compared to baseline and there were no significant differences between the two groups. However,at 12 week improvement in pain score and Lequesne Index was found in favour of hyaluronic acid. In addition,diprospan seemed to have preferable short-term effect on patient with joint effusion. Conclusion Both intra-articular injection of sodium hyaluronate and diprospan provided clinically significant improvement in short-term and demonstrated that hyaluronic acid had a more long-term beneficial effect in patients with knee osteoarthritis.

The effect of triptolide on proliferation and apoptosis of human multiple myeloma RPMI-8226 cells in vitro, as well as the roles of nuclear factor-kappa B (NF-κB) and IκBα was investigated. The effect of tritptolide on the growth of RPMI-8226 cells was studied by MTT assay. Apoptosis was detected by Hoechest 33258 staining and Annexin V/PI double staining assay. The expression of NF-κB and IκBα was observed by Western blot and confocal microscopy. The results showed that triptolide inactivated NF-κB apoptotic pathway in human multiple myeloma RPMI-8226 cells. Triptolide at nM range induced proliferation inhibition in a dose- and time-dependent manner and apoptosis in a dose-dependent fashion in RPMI-8226 cells. Besides, we observed the inhibition of NF-κB /p65 in the nuclear fraction was correlated with the increase in the protein expression of IκBα in the cytosol. These results suggested that triptolide might exhibit its strong anti-tumor effects via inactivation of NF-κB/p65 and IκBα.

ObjectiveTo study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis (TA). MethodsThe clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. ResultsThere were 136 female and 37 male patients in this study. The mean age at onset was(26±11 ) years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6％, 41.1％, 28.7％ of patients, respectively. The distribution of arterial involvement were 64.7％in aorta, 9.8％ in pulmonary artery, 19.1％ in innominate artery, 65.9％ in common carotid arteries, 65.3％in the subclavian artery, 36.2％ in the renal artery, 12.1％ in the vertebral artery, and 5.8％ in coeliac axis.Elevated erythrocyte sedimentation rate(ESR) was found in 61.0％ patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients(26.0％). Ten patients(5.8％) were hepatitis B virus carriers.Among 105 followed-up patients, 98 patients(94.2％) achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. ConclusionCorticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.

Objective To explore the effect of team-based individualized health management on health literacy and health status among hypertensive patients in community. Method This study was a self-controlled quasi-experimental design. A two-stage cluster random sampling method was used. Two neighborhood committees among 23 neighborhood committees in Desheng community were randomly sampled. The name list of hypertensive patients were obtained from the 2 sampled neighborhood committees, getting one from each five, 470 in total before intervention and 444 in total after. The two groups of patients before and after intervention had comparability in the social demographic characteristics as the age (67.16± 9.84, 66.47 ± 10.50 years), the gender (the male accounted for 47.00%and 44.10%), the ethnicity (the Han accounted for 93.80%and 92.30%) and the marital status(the married accounted for 91.30%, 88.90%)(t=1.447 χ2 =0.774, 1.595, 2.555, P>0.05). Since July 2013, Desheng community health service center intervened the hypertensive patients by team-based individualized health management. After one year, we compared the change of their health literacy and health status. Result After health management, the proportion of hypertensive patients with adequate health literacy increased from 38.50% to 53.40%, The average rate of health knowledge awareness among them increased from 65.30% to 75.30%. The average accuracy of health services utilization skills of them increased from 49.10%to 70.90%, lifestyle behaviors in dietary and in exercise the average increase was from 35.55, 17.07 to 37.05, 21.28 respectively, after the intervention the patients did better work in self management behavior, such as self-test of blood pressure, medication compliance and control of salt intake (74.40%, 87.60%, 80.00%) were obviously better than before intervention (61.30%, 68.30%, 62.20%), and the differences were statistically significant (χ2 =16.813, 48.295, 52.058, P<0.05). After health management, the self-report health was better among hypertensive patients. The proportion of them with normalized blood pressure increased from 72.90% to 79.50%, and the difference was statistically significant (P<0.05). Conclusion Team-based individualized health management could increase health literacy of hypertensive patients in community and improve their health status obviously.

Objective To evaluate the safety and feasibility and clinical effectiveness of living relative donor kidney transplantation(LDKT)and summarize its clinical experience. Methods The clinical data of 30 cases of LDKT were retrospectively analyzed.Except for 2 cases being donated by spouse,the others were donated by blood relative donors.6 cases shared two haplotypes,and 22 cases shared one haplotype,and one case 4 mismatched,and 1 fully mismatched.All donors underwent open nephroectomy,in which 7 cases donated right kidneys and 23 donated left kidneys.In 30 cases of recipients,1 case received cadaver donor kidney transplantation and lost her allograft because of superacute rejection.Triple-combined immunosuppressive protocols consisted of calcineurin inhibitor (CNI),mycophenolate mofetil(MMF)or azathioprine(AZa)and steroid. Results All donors'hospital stay was 7 to 10 days postoperatively without any surgical complications. All donors kept their normal kidney function within 3 to 6 months'follow-up.Except for 1 case of death because of lung in fection,29 cases of recipients survived,in which 28 cases kept their normal function kidney within 1 to 4 years of follow-up and 1 case occurred chronic allograft nephropathy after one year.Except one case of DGF,29 cases of recipients retained their normal kidney function in 3 to 5 days postoperatively.Rejection episodes occurred in 4 cases,of which 3 cases were reversed by methylprednisone and 1 case by antithymocyte globulin(ATG)and Tacrolimus.Pneumonia developed in 3 cases,of which 2 cases were cured and 1 case failed.Hematoma was found around allograft in 1 case and wag surgi cally removed.Urinary leakage was happened in 2 cases of recepients and were cured by conservative treatment. Conclusions LDKT is safe and feasible with good long-term results and more advantages such as optimal HLA matches and less ischemia time and lower acute rejection,low-dose immunosup pressants.