Objective To investigate the effect of early goal lactate clearance rate therapy in patients with severe sepsis or septic shock.Methods Articles were retrieved from PubMed,Embase,Cochrane Library,Wanfang and CNKI before March 5,2016.Inclusion criteria included the subjects concerning patients with severe sepsis or septic shock reported as randomized controlled trial (RCT),which endpoints were the mortality,the length of ICU stay and hospital stay.RevMan 5.3 software was used for Meta analysis.Results There were 5 RCTs meeting inclusive criteria including 860 patients.It was shown by Meta analysis that early goal lactate clearance rate therapy was associated with decrease in the 28-day mortality(RR =0.73,95％ CI:0.60-0.88,P ＜ 0.01),shorten the length of ICU stay (WMD =-2.41,95％ CI:-4.68--0.14,P ＜ 0.05),but not associated with decrease of the length of hospital stay(WMD =-0.13,95 ％ CI:-4.58-4.31,P =0.95).Conclusion Early goal lactate clearance rate therapy was associated with significant improvement in 28-day mortality and the length of ICU stay but not with the length of hospital stay in patients with severe sepsis or septic shock.

BACKGROUND: Scoparone,which is a major principle separated from traditional Chinese herbs artemisia scoparia, which possesses actions of immunosuppression, anti-inflammation and relaxing bronchial smooth muscle. It' s not known whether scoparone possesses the regulation of the imbalance of interferon-gamma(IFN-γ) and interleukin-4(IL-4) in asthmatic guinea pig.OBJECTIVE: To investigate the inhibition and immunoregulation of scoparone on asthmatic guinea pig.DESIGN: Randomized controlled study based on the experimental animals.SETTING: Department of ethnopharmaeology in a university.MATERIALS: The experiment was completed in the Department of Ethnopharmacology,China Medical University between July 2000 and March 2002. Totally 84 male guinea pigs were selected at sanitation grade,weighting about(200 ± 50) g.INTERVENTIONS: The ameliorative effects of scoparone on the imbalance of IFN-γ and IL-4 in asthmatic guinea pigs were investigated by using the acute and delayed asthmatic guinea pigs which were respectively challenged by the aerosol mixture of 10 g/L histamine and 1 g/L acetylcholine,and 10 mL/L ovalbumin.MAIN OUTCOME MEASURES: The asthmatic latent periods in acute and delayed asthma, and the levels of IgE, IL-4 and IFN-γ in serum and pulmonary tissue homogenate in the asthmatic animals.RESULTS: Scoparone significantly prolonged the asthmatic latent periods in acute and delayed asthma,observably reduced the levels of IgE and IL-4 and raised the content of IFN-γin serum and pulmonary tissue homogenate in the asthmatic animals (P<0. 05).CONCLUTION: The anti-asthmatic effects of scoparone result from the ameliorative effects on the imbalance of IFN-γ/IL-4 ratio thereby to inhibit the abnormal synthesis of IgE.

0.05). Conclusion Ryanodine receptor of asthmatic guinea-pig showed hypersensitivity. Under specified condition, the characteristics of ryanodine receptor still retains in subcultured ASMCs of asthmatic guinea-pig.

AIM To study the changes of IgE, IL-4 and IFN-y in serum and pulmonary tissue homogenate of asthmatic guinea pigs and the effects of scoparone on them. METHODS To divide animals into three groups: control, asthma and scoparone treatment groups. Choose the model guinea pigs of asthma sensitized with OA, and observe the changes of IgE, IL-4 and IFN-r in serum and pulmonary tissue homogenate of asthmatic guinea pigs and the effects of scoparone on them by means of chemolumi nescence, radio immunoassay, enzyme-linked immunoabsordent assay. RESULTS IgE and IL-4 in serum and pulmonary tissue homoge-nate of asthmatic guinea pigs obviously increase (P

Objective To study the diagnostic and treatment value of wire guided localization of breast biopsy for non-palpable breast lesions.Methods The clinical data of 314 cases of non-palpable breast lesion resection operation in our hospital were retrospectively analyzed.The accuracy rate of resection and postoperative pathological examination results were analyzed.Results All lesions were positioned accurately and completely resected,48 cases in 314 cases were breast cancer(15.3 ％),in which 42 cases were early breast cancer which were confirmed by pathology (87.5％).Conclusion Wire guided localization of breast biopsy has high accuracy,low cost,which is useful for the diagnosis of early breast cancer,there is a certain value in clinical application.

Informed consent right is not just for basic ethical consideration, but is important for protecting patient's right by law, which is expressed through informed consent contract. The appraised individuals of forensic clinical examination have the similar legal status as the patients in medical system. However, the law does not require informed consent right for the appraised individuals. I recommend giving certain informed consent right to the appraised individuals in the forensic clinical examination. Under the contracted relationship with the institution, the appraised individuals could participate in the examination process, know the necessary information, and make a selected consent on the examination results, which can assure the justice and fairness of judicial examination procedure.
Forensic Medicine ; Humans ; Informed Consent ; Patient Participation

Objective To evaluate the value of reducing radiation dose with ECG-pulsing and image quality in 64-row multi-alice CT coronary angiography.Methods Fifty-nine consecutive patients whose heart rates were less than 80 beat per minute and cardiac rhythm was regular were randomly divided into two groups from October 26, 2007 to March 12, 2008.Conventional technique of CT coronary angiography was employed in group 1, while ECG-pulsing technique was applied in group 2.CT dose index volume (CTDIvol) and dose length product (DLP) were obtained automatically, and then the corresponding effective dose (ED) were calculated.The quality scores were performed on obtained imaging by using double blind method.Student t-test was applied in the comparison of value of CTDIvol, value of ED and quality of imagiugbetween two groups.Results The value of CTDIvol was (70.0±1.1) and (39.0±2.7) mGy, the value of ED was (16.8±2.0) and (9.5±1.7) rosy in group 1 and group 2, respectively, which reached statistically significant differences between the groups(t=57.675,15.346 ,P <0.01, respectively). The quality scores of coronary images were 3.8±0.2 and 3.8±0.1 in the groups, which did not reach the statistical significance (t=-0.222, P 0.05).Conclusions The proper application of ECG-Pulsing technology in 64-slice spiral CT coronary angiography can reduce radiation dose significantly while having no influence on the quality of the imaging.

Objective To analyze the clinical features,therapeutic effect and prognosis in patients with bone pain induced by malignant bone me?tastasis as well as the rationality of analgesic application,so as to improve the level of diagnosis and treatment for metastatic bone pain. Methods Totally 123 patients with pain due to malignant bone metastasis received antitumor therapy and analgesic therapy based on standardized three?step guidelines. Their clinical characteristics were retrospectively analyzed. Results The total pain relief rate was 85.4%and the pain was significantly relieved(P<0.05). The DUI value of each narcotic agent was close to 1 and the application of narcotic agents tended to be rational. The Kaplan?Meier survival analysis showed that patients with moderate pain had longer survival time than those with severe pain(P=0.015). The survival rate of patients with significant pain relief after treatment was higher than those unrelieved(P=0.021). The survival rate of patients without visceral me?tastasis was higher than those with visceral metastasis(P=0.000). The COX multivariate analysis indicated that the pain intensity and visceral me?tastasis were independent risk factors influencing patient prognosis. Conclusion Standard treatment can improve symptoms in most patients with bone metastasis and prolong survival time. Opioids have satisfactory analgesic effect for moderate to severe pain and the adverse reactions can be tol?erated.

Aim To investigate estradiol inhibition of neointimal proliferation after rat carotid artery balloon injury. Methods Eight to ten-week-old SD rats (male,n=21,female,n=21) were divided into intact control(n=7),gonadectomy control(n=7) and estradiol (n=7, gonadectomy)groups in each sex. Left carotid artery was not injured with 2.0 F PTCA balloon until estradiol was injected for three days. Rats were killed 2 wk after injury. Neointimal areas and media area, ratios of intimal areas/media areas were measured with computer. Results Male neointimal areas and ratios of intimal areas /media areas in estradiol group were less than those in intact control group significantly(all P0.05). Conclusions Estrdiol inhibits neointimal proliferation after the gonadectomy in rats undergoing carotid artery balloon injury.

Polysaccharide sulfate (PSS) is a new type of antiatherosclerotic medicine for its effects of anticoagulation, anti-thrombosis and modulation of dyslipidemia. However, it is still uncertain whether PSS could modulate the diabetic dyslipidemia or not. Here, the rat model of diabetic dyslipidemia was developed and the effects of PSS on glucose and lipid levels were investigated in this animal model. Wistar rats were iv injected with streptozotocin 20 mg·kg-1 after feeding with high fat diet for one and a half month. Then, rats received orally PSS (30, 90, and 180 mg·kg-1) for 1 month. After oral treatment with PSS (90 and 180 mg·kg-1) for 1 month, the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) were significantly reduced and the level of high density lipoprotein-cholesterol (HDL-C) increased, compared with diabetic control rats. Moreover, PSS (30, 90, and 180 mg·kg-1) had a tendency to reduce glucose and insulin levels, and significantly increased insulin sensitivity index. Our results suggest that PSS could improve insulin sensitivity and relieve dyslipidemia in diabetic dyslipidemic rats.