Objective To evaluate the combination of the mortality in emergency department sepsis (MEDS) score with blood lactate level in the risk stratification of patients with severe sepsis in the emergency department (ED).Methods 665 adult patients with severe sepsis admitted from May 2011 to December 2012 in ED were found to be eligible for the study.MEDS score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,and arterial blood lactate was determined,and the outcomes in 28 days were recorded.Logistic regression analysis was used to evaluate the relationship between each predictive factor score and prognosis.Each predictive factor was compared with the areas under the receiver operating characteristics (ROC) curve (AUC).Results The mortality in 28 days was 34.6％ in 665 patients.The mortality in group of MEDS score 12-27 was significantly higher than that group of MEDS score＜12 [51.0％ (156/306) vs.20.6％ (74/155),x2=28.414,P=0.000].In the meantime,APACHE Ⅱ score and blood lactate level were also significantly higher in group of MEDS score 12-27 than those in group with MEDS score＜12 [APACHE Ⅱ score:26.4 ± 10.6 vs.21.7 ± 8.1,t=-3.555,P=0.002; lactate (mmol/L):4.9 (2.3,9.9)vs.3.9 (1.5,8.9),Z=-2.352,P=0.023].Kaplan-Meier survival analysis showed significantdifference in the two groups (the Log Rank test 36.71,P ＜0.01).The levels of 3 predictive factors were predominantly higher in non-survivors than survivors [MEDS score:14.1 ± 6.7 vs.8.2 ± 4.5,t=-6.929,P=0.000; APACHE Ⅱ score:28.1 ±7.1 vs.22.2± 11.3,t=-6.472,P=0.000; lactate (mmol/L):5.4 (2.9,11.0) vs.3.8 (1.2,9.1),t=-6.472,P=0.004].The AUCs were 0.813,0.706 and 0.727 for MEDS score,APACHE Ⅱ score and blood lactate respectively.The predictive ability for 28-day mortality of MEDS score was better than blood lactate (P=0.008) and APACHE Ⅱ score (P=0.005).The AUC of MEDS score combined with lactate was 0.865,and 28-day mortality prediction was better than MEDS score (AUC 0.865 vs.0.813,P＜0.001).The sensitivity (83.1％),specificity (93.2％),positive prediction value (PPV,62.4％),and negative prediction value (NPV,92.1％) for MEDS score combined with lactate were highest among all predictors.Conclusion MEDS score combined with lactate is a good risk stratification tool for emergency patients with severe sepsis,and its prognostic capability is better than either MEDS score,APACHE Ⅱ score or blood lactate.

Culture environment is the key factor in the construction of dermal skin.It was investigated that the effects of the culture methods,including the static culture and spinner flask culture,and stir speeds on the cells proliferation,metabolism and distribution within collagenchitosan sponges.A higher cell density and specific growth rate was obtained with spinner flask culture versus static culture,especially,the 80 r/min spinner flask culture.The cell distribution in dermal substitutes from stirred culture system was more uniform than static culture,as well as that with increase of stir speeds in spinner flask.In summary,the spinner flasks culture with proper stir speed shows promise for the construction of dermal substitutes in vitro.

OBJECTIVETo observe the therapeutic effect of propranolol with 1 064 nm Nd:YAG laser on proliferating hemangioma in body surface.

METHODS97 patients with proliferating hemangiomas in body surface were randomly assigned to three groups: A group (32 patients were treated by propranolol with 1064 nm Nd:YAG laser), B group (35 patients were treated by 1064 nm Nd:YAG laser), C group (30 patients were treated by propranolol). Their visual analog scores, clinical outcomes and adverse events were compared respectively.

RESULTS18 weeks later, A group had a mean visual analog score of 65.50 +/- 16.55, compared with 54.03 +/- 20.13 in B group, 28.08 +/- 30.34 in C group (P < 0.05); 24 weeks later, the mean visual analog scores of three groups were 76.88 +/- 19.05, 63.89 +/- 19.43 and 45.48 +/- 31.86 (P < 0.05). After 24 weeks' treatment, 9 cases (28.1%) in A group, 3 cases (8.6%) in B group, 1 cases (4.0%) in C group obtained complete healing (P < 0.05). To effect of adverse events in body surface, the mean score of B group was higher than the scores of A group and C group (P < 0.05).

CONCLUSIONSPropranolol with 1064 nm Nd:YAG laser is effective and safe in the treatment of proliferating hemangioma.

Angiogenesis Inhibitors ; therapeutic use ; Combined Modality Therapy ; methods ; Hemangioma ; therapy ; Humans ; Lasers, Solid-State ; therapeutic use ; Propranolol ; therapeutic use ; Skin Neoplasms ; therapy

Objective To evaluate the effect of application of clinical nursing pathway to treatment of acute ST--Elevation myocardial infarction (STEMI).Methods A total of 60 STEMI patients were divided into two groups.Experimental group were received treatment and care according to the designed STEMI clinical pathway table.Control group were treated and nursed with the conventional emergency mode.Results The time of emergency PCI of the experimental group was less than teat of control group(P<0.05)treatment success rate was higher than the control group.Total hospital costs,medicine costs and hospital days were significantly lower in experiment group,while health education and satisfaction were significantly higher(P <0.05).Conclusions The application of clinical pathway in the STEMI could win precious time of their treatment for patients,reduce medical costs and improve quality of care.It is in line with the current demand of China's health system and therefore is worth to promoting.

OBJECTIVETo study the genetic association of apolipoprotein (apo) E and apoCI gene polymorphisms with coronary heart disease (CHD) in China.

METHODSapoE genotypes were identified by multiplex amplification refractory mutation system (multi-ARMS) and the apoCI promoter polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 186 cases with CHD (age: 65.0 +/- 10.5 years) and 350 controls (age: 63.6 +/- 8.3 years). The haplotype frequencies were estimated.

RESULTSThe frequencies of apoE E4/3 genotype (26.9%) and epsilon4 (14.5%) in CHD group were significantly higher than that in the control group (12.6%, 7.0%), P <0.05. The significant difference was also found for the apoCI locus and the CHD group showed higher rate of both for the H2 allele and genotypes, carrying this allele. Estimation of the haplotype frequencies indicated that the association between the apoE-CI haplotype and CHD was significantly strong. The apoE-epsilon4/apoCI-H2 was estimated to be responsible for 9.86% of CHD.

CONCLUSIONWhen the subjects carrying both epsilon4 and H2 alleles, they would have higher risk of suffering from CHD than controls.

Adult ; Aged ; Aged, 80 and over ; Alleles ; Apolipoproteins C ; genetics ; Apolipoproteins E ; genetics ; China ; epidemiology ; Coronary Disease ; blood ; epidemiology ; genetics ; Female ; Genotype ; Haplotypes ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Risk Factors

Antiviral Agents ; adverse effects ; therapeutic use ; Female ; Hepatitis C, Chronic ; complications ; drug therapy ; psychology ; Humans ; Interferon-alpha ; adverse effects ; therapeutic use ; Mental Disorders ; complications ; Middle Aged

Cell seeding of three-dimensional scaffolds is the first step of the cultivation of engineered tissues. The cell seeding density and spatial distribution in a 3-D scaffold are critical to the morphogenetic development of an engineered tissue. In the present work, human fibroblasts were seeded to collagen-chitosan sponges by static seeding, stirred seeding and perfusion seeding. The effects of seeding conditions on the resulting seeding density, the seeding efficiency and the initial cell distribution were studied. The seeding efficiency was relatively high (88.9%) at low inoculation cell density, and decreased rapidly wjth the increasing of inoculation cell density in static seeding. Stirred seeding yielded the lowest seeding efficiency. Nonuniform initial cell distribution was observed in both static and stirred seeding. The perfusion seeding, which has a characteristic of high seeding efficiency (>77%) , high initial cell density and uniform initial cell distribution in 3-D scaffolds, is the optimum method for cell seeding to 3-D scaffold.
Cell Aggregation ; Cell Count ; methods ; Cell Culture Techniques ; methods ; Cells, Cultured ; Chitosan ; chemistry ; Collagen ; chemistry ; Fibroblasts ; cytology ; Humans ; Skin ; cytology ; Tissue Engineering ; methods ; Tissue Scaffolds

OBJECTIVETo make an inquiry into method of typing of hemorrhagic fever with renal syndrome (HFRS).

METHODAverage monthly rates were calculated on the basis of data from 1995 to 1999, then cluster analysis was carried out to type out endemic areas.

RESULTSCompared with the results of 36 surveillance spots from 1980 to 1992, twenty-four surveillance spots had the same results (66.7%). Twenty-three surveillance spots had the same results with the original data in 1999 (82.1%).

CONCLUSIONHFRS incidences increased in spring or in summer, but decreased in autumn or in winter. Cluster analysis seemed to be a supplementary method in distinguishing the epidemic types for HFRS.

Animals ; China ; epidemiology ; Cluster Analysis ; Disease Reservoirs ; Hantaan virus ; isolation & purification ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; Humans ; Incidence ; Population Density ; Seasons ; Sentinel Surveillance

OBJECTIVETo investigate the protective effects of sodium tanshinone B (STB) on brain damage following focal ischemia-reperfusion (I/R) injury through interfering with N-methyl-D-aspartic acid receptor (NMDAR) and excitatory and inhibitory amino acids, and evaluate the potential mechanisms of the neuroprotective activity of STB.

METHODSTransient forebrain ischemia was induced by middle cerebral artery occlusion (MCAO). The rats were randomized into a sham operated group, a model group (I/R) and three STB different dose groups. Rats were pretreated with STB at the doses of 4, 8, 16 mg/kg (STB(1), STB(2), STB(3)) for 3 days before MCAO. The expression of NMDAR1 was detected by immunohistochemistry and Western blotting. The concentrations of glutamate and γ-aminobutyric acid (GABA) were analyzed using high performance liquid chromatography.

RESULTSSTB treatment reduced neurological defect scores, cerebral infarction volume and brain water content. The levels of NMDAR1 were significantly higher in the l/R and STB(1) groups than that of the sham and the STB(3) groups (P<0.01). Optical density of NMDAR1 was significantly increased in cornu ammonis (CA)1 region of the l/R group (P<0.05). STB treatment reduced NMDAR1 optical density in the CA1 region (P<0.01). The levels of glutamate were significantly lower in the hippocampus in the STB(3) group than that of the l/R, STB(1) and STB(2) groups (P<0.01).

CONCLUSIONPreconditioning with STB appears to be a simple and promising strategy to reduce or even prevent cerebral l/R injury and has potential for future clinical application.

Animals ; Brain Ischemia ; pathology ; Cytoprotection ; drug effects ; Disease Models, Animal ; Diterpenes, Abietane ; pharmacology ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; pharmacology ; Hippocampus ; drug effects ; pathology ; Models, Biological ; Neurons ; drug effects ; pathology ; physiology ; Neuroprotective Agents ; pharmacology ; Random Allocation ; Rats ; Reperfusion Injury ; pathology ; Treatment Outcome

OBJECTIVETo evaluate in vivo the remineralization containing trace elements.

METHODSThe volunteers were selected by pre-designed criteria of adopting and eliminating. Caries-like lesions were prepared in the enamel of extracted human premolars with the use of demineralizing solution. Sections of the normal and lesion enamel (approximately 2 mm x 2 mm) were prepared, with the cut surfaces protected by nail varnish. 2 enamel specimens were mounted in a removable appliance. By measuring lesion parameters (area, total and average dye fluorescence) on a tooth with confocal laser scanning microscopy (CLSM), the effect of remineralization was assessed. Specimens were cut and stained with a fluorescent dye (0.1 mmol/L rhodamine B) for 1 h and analyzed using CLSM.

RESULTSCLSM detected significantly greater remineralization (P < 0.05) in the specimens treated with the trace elements fluoride-containing solution and only containing fluoride (P < 0.05), especially more obvious difference was shown upon remineralized solution with trace elements, which means it produced a greater remineralization. CLSM data of remineralized solution with trace elements were showed: delta Z vs. Area = -50.4 +/- 8.1; delta Z vs. TF = -27.8 +/- 3.8; delta Z vs. AF = -91.5 +/- 8.9.

CONCLUSIONSThe ability of remineralization of the new solution is better than that only containing fluoride in in vivo study. It can potentially prevent initiation of caries. This study provides not only the theoretical foundation for clinical application, but also shows a new kind of experimental method in the study of demineralization and remineralization.

Dental Caries ; drug therapy ; metabolism ; Dental Enamel ; drug effects ; metabolism ; Fluorides ; pharmacology ; Humans ; Microscopy, Confocal ; Tooth Remineralization ; methods ; Trace Elements ; pharmacology